Page 93 - Depression in adults: treatment and management

Depression in adults: treatment and management (NG222)

MBCT, with their advice framed to take into account the therapy the person had already received.

The committee agreed that psychological therapies used for relapse prevention should explicitly
focus on relapse prevention skills.

The committee used their knowledge and experience to recommend follow-up arrangements for
people on relapse prevention therapy, to ensure that people did not remain on therapy indefinitely.

As there was little evidence for the use of brief courses of psychotherapy or maintenance
electroconvulsive therapy (ECT) in preventing relapse, the committee made a research

recommendation on the effectiveness and cost effectiveness of brief courses of psychological
treatment and a research recommendation on maintenance ECT.

How the recommendations might affect practice How the recommendations might affect practice

The recommendations reflect current practice, but may reduce variation in practice across the

NHS. Commissioners and services will need to provide therapies with an explicit relapse prevention
component.

Return to recommendations

Further-line treatment Further-line treatment

Recommendations 1.9.1 to 1.9.9 and 1.13.1 to 1.13.9

Why the committee made the recommendations Why the committee made the recommendations

The committee made recommendations based on their knowledge and experience that people's
symptoms may not respond to treatment for depression for a number of reasons, and that these

reasons should be explored and addressed before considering further-line treatment.

No evidence was identified for people whose depression had not responded to the use of
psychological therapies as first-line treatment, but the committee used their experience to
recommend further-line treatment options for people whose depression had initially been treated

with psychological therapies. As there was no evidence for people whose symptoms did not
respond to initial psychological treatments, the committee made a research recommendation on
further-line treatment.

For people whose depression had not responded to antidepressants, there was some evidence that
augmenting antidepressant regimens with group exercise was effective. There was also some very

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