CG123 Common mental health disorders - National Institute for ...

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Further assessment of risk and need for treatment, and routine outcome monitoringTable 32: Preliminary summary and synthesis of selected text fromrecommendations relating to personal characteristics (by guideline) tosupport the process of adoption and adaptationGuidelineAlcohol-use Disorders(NICE, 2011b)Antenatal and PostnatalMental Health (NICE, 2007a)(For common mental healthdisorders only)Depression (NICE, 2009a)Depression in Adults with aChronic Physical HealthProblem (NICE, 2009b)Drug Misuse: OpioidDetoxification (NICE, 2007c)Drug Misuse: PsychosocialInterventions (NICE, 2007b)Generalised Anxiety Disorderand Panic Disorder (with orwithout Agoraphobia) inAdults (NICE, 2011a)Obsessive-compulsiveDisorder (NICE, 2005a)Post-traumatic Stress Disorder(NICE, 2005b)RecommendationNone identifiedWhen prescribing a drug for a woman with a mentaldisorder who is planning a pregnancy, pregnant orbreastfeeding, prescribers should:• choose drugs with lower-risk profiles for the motherand the fetus or infant• start at the lowest effective dose, and slowly increase it; thisis particularly important where the risks may be dose related• use monotherapy in preference to combination treatment• consider additional precautions for preterm, low birthweight or sick infants.Do not routinely vary the treatment strategies for depressiondescribed in this guideline by personal characteristics(for example, sex or ethnicity) as there is no convincingevidence to support such action.None identifiedNone identifiedNone identifiedThe following must be taken into account whendeciding which medication to offer:• the age of the person• risks• the likelihood of accidental overdose• the likelihood of deliberate self-harm, by overdose orotherwise.Obsessive-compulsive symptoms may sometimesinvolve a person’s religion, such as religious obsessionsand scrupulosity, or cultural practices. When the boundarybetween religious or cultural practice and obsessivecompulsivesymptoms is unclear, healthcare professionalsshould, with the patient’s consent, consider seeking theadvice and support of an appropriate religious or communityleader to support the therapeutic process.For adults with OCD living with their family or carers,involving a family member or carer as a co-therapist in ERPshould be considered where appropriate and acceptable.None identified159
Further assessment of risk and need for treatment, and routine outcome monitoringTable 33: Prelimiary summary and synthesis of selected text fromrecommendations relating to service user preference (by guideline) to supportthe process of adoption and adaptationGuidelineRecommendationAlcohol-use Disorders None identified(NICE, 2011b)Antenatal and Postnatal Consider antidepressant treatment if the womanMental Health (NICE, 2007a) has expressed a preference for it.(For common mentalhealth disorders only)Depression (NICE, 2009a) For people with depression who decline anantidepressant, CBT, IPT, behavioural activationand behavioural couples therapy, consider:• counselling for people with persistentsubthreshold depressive symptoms or mild tomoderate depression• short-term psychodynamic psychotherapy forpeople with mild to moderate depression.For people with depression who are at significantrisk of relapse or have a history of recurrentdepression, discuss with the persontreatments to reduce the risk of recurrence,including continuing medication, augmentationof medication or psychological treatment(CBT). Treatment choice should be influencedby the person’s preference.Depression in Adults with The choice of intervention should bea Chronic Physical Health influenced by the patient’s treatment preferenceProblem (NICE, 2009b) and priorities.Drug Misuse: Opioid None identifiedDetoxification (NICE, 2007c)Drug Misuse: Psychosocial None identifiedInterventions (NICE, 2007b)Generalised Anxiety Inform people with GAD who have not receivedDisorder and Panic or have refused treatment offered in Steps 1 to 3Disorder (with or without of the potential benefits of such treatments.Agoraphobia) in Adults Offer them whichever treatments have not(NICE, 2001a)been tried.160Continued
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Commonmental healthdisordersTHE NIC
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© The British Psychological Societ
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Contents6 FURTHER ASSESSMENT OF RIS
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Guideline development group members
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Preface1 PREFACEThis guideline has
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Prefacecollaborative manner using t
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PrefaceThe experience of people wit
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Common mental health disorders2.2 T
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Common mental health disordersto ho
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Common mental health disordersManua
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Common mental health disordershighe
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Common mental health disordersNegat
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Common mental health disorderscours
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Common mental health disordersover
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Common mental health disorders2.2.6
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Common mental health disordersTable
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Common mental health disorders1996)
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Common mental health disordersSumma
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Common mental health disordersTable
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Common mental health disordersappli
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Common mental health disorderspatie
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Methods used to develop this guidel
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Access to healthcare4. ACCESS TO HE
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Access to healthcareunder the Menta
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Access to healthcare4.2.3 Studies c
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Access to healthcareIndividual-leve
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Access to healthcareJUNG2003 review
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Access to healthcareSCHEPPERS2006).
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Access to healthcare70Table 8: Clin
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Access to healthcareTable 9: Study
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Access to healthcareCHAPMAN2004 inc
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Access to healthcare4.4 SERVICE DEV
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Access to healthcareBEACH2006 [Beac
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Access to healthcareTable 12: Summa
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Access to healthcareAll studies wer
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Access to healthcarepractitioners h
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Access to healthcareIndividual-leve
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Access to healthcarefrom such popul
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Access to healthcarestructure and d
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Case identification and formal asse
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Systems for organising and developi
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Summary of recommendations8.1.1.6 S
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Summary of recommendationsFigure 12
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Summary of recommendations●Genera
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Summary of recommendations8.4 STEPS
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Summary of recommendations●●a g
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Summary of recommendationsDiscuss w
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Summary of recommendationsinclude p
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Appendices9 APPENDICESAppendix 1: S
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Appendix 1of a depressive disorder
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Appendix 1b) Assessment of anxiety
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Appendix 2APPENDIX 2:DECLARATIONS O
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Appendix 2Mr Mike BessantEmployment
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Appendix 2Personal non-pecuniary in
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Appendix 2Actions takenMr Rupert Su
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Appendix 2Personal family interestN
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Appendix 3APPENDIX 3:STAKEHOLDERS A
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Appendix 4ClinicalpopulationPeople
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Appendix 4Case identificationNo. Pr
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Appendix 5APPENDIX 5:REVIEW PROTOCO
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Appendix 7APPENDIX 7:METHODOLOGY CH
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Appendix 9APPENDIX 9:METHODOLOGY CH
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Appendix 92.10 Are all important pa
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Appendix 9case also excludes costs
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Appendix 9For consistency, the EQ-5
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Appendix 9Answer ‘yes’ if the a
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Appendix 9Answer ‘yes’ if the e
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Appendix 9Answer ‘yes’ if appro
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Appendix 10APPENDIX 10: EVIDENCE TA
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Appendix 11APPENDIX 11:HIGH PRIORIT
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Appendix 11discussion of options bu
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Appendix 13APPENDIX 13:GENERALIZED
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ReferencesAndlin-Sobocki, P., Jöns
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ReferencesBower, P., Gilbody, S., R
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ReferencesCooper, S., Smiley, E., M
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ReferencesEhlers A., Gene-Cos N. &
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ReferencesGiles, D. E., Jarrett, R.
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ReferencesHorowitz, M. J., Wilner,
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ReferencesKnapp, M. & Ilson, S. (20
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ReferencesMarks, J., Goldberg, D. P
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ReferencesNCCMH (forthcoming) Self-
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ReferencesOzer, E. J., Best, S. R.,
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ReferencesSartorius, N. (2002) Eine
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ReferencesTiemens, B. G., Ormel, J.
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ReferencesWilkinson, M. J. B. & Bar
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Glossarybeliefs and interpretations
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Glossaryto learn to become more awa
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Abbreviations12 ABBREVIATIONSADDADS
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AbbreviationsOASISOCDONSORPHQ (-A,
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