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

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Further assessment of risk and need for treatment, and routine outcome monitoringTable 35: Step 2 treatment and referral adviceDisorder Psychological interventions Pharmacological interventions Psychosocial interventionsDepression –persistentsubthresholdsymptoms or mildto moderatedepressionOffer or refer for one or more of thefollowing low-intensity interventions:• individual facilitated self-help basedon the principles of CBT• CCBT• a structured group physical activityprogramme• a group-based peer support (self-help)programme (for those who also have achronic physical health problem)• non-directive counselling delivered athome (listening visits) (for womenduring pregnancy or the postnatalperiod) a,b,c .GAD – that has not Offer or refer for one of the following N/Aimproved after low-intensity interventions:psychoeducation • individual non-facilitated self-helpand active • individual facilitated self-helpmonitoring in Step 1 • psychoeducational groups d .Do not offer antidepressants routinelybut consider them for, or refer for anassessment, people with:• initial presentation of subthresholddepressive symptoms that have beenpresent for a long period (typically atleast 2 years) or• subthreshold depressive symptoms ormild depression that persist(s) afterother interventions or• a past history of moderate or severedepression or• mild depression that complicates thecare of a physical health problem a,b .Consider:• informing people about selfhelpgroups, support groupsand other local and nationalresources• educational and employmentsupport services a .Panic disorder – Offer or refer for one of the following N/Amild to moderate low-intensity interventions:• individual non-facilitated self-help• individual facilitated self-help.OCD – mild to Offer or refer for individual CBT N/Amoderate including ERP of limited duration(typically up to 10 hours), whichcould be provided using self-helpmaterials or by telephone orRefer for group CBT (including ERP) e,f .Continued171
Further assessment of risk and need for treatment, and routine outcome monitoringDisorder Psychological interventions Pharmacological interventions Psychosocial interventionsPTSD – including Refer for a formal psychological N/A Consider:mild to moderate intervention (trauma-focused CBT or • informing people aboutPTSD EMDR) g . support groups and otherlocal and national resources• educational and employmentsupport services a .Table 35: (Continued)g Adapted from Post-traumatic Stress Disorder (NICE, 2005b).All disorders – For women who have had a previous When considering drug treatments for For women who have notwomen planning a episode of depression or anxiety, women who are pregnant, breastfeeding had a previous episode ofpregnancy, during consider providing or referring for or planning a pregnancy, consult depression or anxiety,pregnancy or individual brief psychological treatment Antenatal and Postnatal Mental Health consider providing orfollowing pregnancy (four to six sessions), such as IPT or (NICE, 2007a) for advice on referring for social supportwho have CBT c . prescribing. during pregnancy and thesubthreshold postnatal period; suchsymptoms that Women requiring psychological support may consist ofsignificantly interventions during pregnancy or the regular informal individual orinterfere with postnatal period should be seen for group-based support c .personal and social treatment within 1 month of (and nofunctioning longer than 3 months from) initialassessment c .a Adapted from Depression (NICE, 2009a).b Adapted from Depression in Adults with a Chronic Physical Health Problem (NICE, 2009b).c Adapted from Antenatal and Postnatal Mental Health (NICE, 2007a).d Adapted from Generalised Anxiety Disorder and Panic Disorder (with or without Agoraphobia) in Adults (NICE, 2011a).e Adapted from Obsessive-compulsive Disorder (NICE, 2005a).f Group formats may deliver more than 10 hours of therapy.172
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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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Page 121 and 122: Case identification and formal asse
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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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