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Cited by 127Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Depression in adults, including those with a chronic physical health problem: summary of NICE guidance

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Pilling, S., Anderson, I., Goldberg, D., Meader, N., Taylor, C., On behalf of the two guideline development groups·2009·BMJ
DOI 10.1136/bmj.b4108PMC PMC3230232
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Abstract

Each year 6% of adults will experience an episode of depression, and over the course of a person’s lifetime more than 15% of the population will have an episode.1 2 3 4 Depression (as defined by the American Psychiatric Association5) is the leading cause of suicide and currently the fourth highest disease burden on society in terms of its treatment costs, its effect on families and carers, and its impact on productivity in the workplace. Depression can be disabling and distressing and for many people can become a chronic disorder, especially if inadequately treated. It is about two to three times more common in people with a chronic physical health problem than in people who are in good physical health.6 Chronic physical health problems can precipitate and exacerbate depression, but depression can also adversely affect outcomes of coexisting physical illnesses, including increased mortality. Furthermore, depression can be a risk factor for some physical illnesses, such as cardiovascular disease.7 This article summarises the most recent recommendations on depression from the National Institute for Health and Clinical Excellence (NICE): an updated guideline on the management and treatment of depression in adults8 and a new guideline on depression focusing on adults with a chronic physical health problem.9 In both guidelines diagnosis was based on the criteria of the Diagnostic and statistical manual of mental disorders , fourth edition (DSM-IV), which require the presence of at least five symptoms and of impaired function persisting for at least two weeks.5 NICE recommendations are based on systematic reviews of the best available evidence. When minimal evidence is available, recommendations are based on the experience and opinion of the Guideline Development Group (GDG) of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. …

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  • Earlier reviews and meta-analyses and recent treatment guidelines for long-term treatment of MDD are generally supportive of treatments continued for several months as well as more than a year, particularly pharmacotherapies.

    “Earlier reviews and meta-analyses and recent treatment guidelines for long-term treatment of MDD are generally supportive of treatments continued for several months as well as more than a year, particularly pharmacotherapies (Geddes et al., 2003; Lam et al., 2009; Pilling et al., 2009; Williams et al., 2009; Glue et al., 2010; Bauer et al., 2015).”

    From Prevention of Relapse and Recurrence in Adults with Major Depressive Disorder: Systematic Review and Meta-Analyses of Controlled Trials (2016) · cites this paper as Pilling et al., 2009

    The Recommendations section, under “Continuation and relapse prevention” (page unavailable), encourages people who benefited from an antidepressant to continue it for at least six months after remission. This supports continuation for several months, particularly pharmacotherapy, but the paper does not specifically recommend treatment for more than a year. (LLM, conf=0.87)

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Research works printed but not linked: 1

  1. [8]National Institute for Health and Clinical Excellence. Depression: the treatment and management of depression in adults (update). 2009 (Clinical guideline 90.) www.nice.org.uk/CG90 31886986

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Authors
Pilling, S., Anderson, I., Goldberg, D., Meader, N., Taylor, C., & groups, O. B. O. T. T. G. D.
Affiliations
  • University College London (GB)
  • University of Manchester (GB)
  • King's College London (GB)
  • Royal College of Psychiatrists (GB)
Corresponding author
Pilling, S.
ORCID
Venue
BMJ
Publisher
BMJ
Published
2009-10-27
Volume
339
Issue
oct27 1
Pages
b4108-b4108
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.b4108
PMC
PMC3230232
OpenAlex
W2015880078
Cited by
127
References
18
Citations by year
2026: 3 · 2025: 3 · 2024: 8 · 2023: 7 · 2022: 10 · 2021: 12 · 2020: 12 · 2019: 7 · 2018: 6 · 2017: 13 · 2016: 7 · 2015: 5 · 2014: 15 · 2013: 4 · 2012: 4
FWCI
3.59
Type
journal article
Language
en
Open access
Locations
  • BMJ (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
depression, adults, comorbidities, depression treatment, NICE guidelines, cardiovascular disease, DSM-IV diagnostic criteria
MeSH terms
Adult, Antidepressive Agents, Chronic Disease, Combined Modality Therapy, Delivery of Health Care, Depressive Disorder, Humans, Patient Compliance, Psychotherapy, Treatment Outcome, Practice Guidelines as Topic, Secondary Prevention

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