12) NICE Guidelines

Question 1

What is the prevalence of depression in women and men?

Answer 1

Women: 4-10%
Men: 2-3.5%

Question 2

What is the lifetime risk of depression in women and men?

Answer 2

Women: 10-26%
Men: 5-12%

Question 3

What did the Layard Report state was needed?

Answer 3

Easy access to self help facilities
5000 extra therapists trained in CBT
More psychiatrists
GPs do 6 months psychiatry with emphasis on depression and anxiety

Question 4

What was the function of IAPT?

Answer 4

More people treated and cured from depression and anxiety
More psychological therapists
GP practices having access to therapies

Question 5

What is step 1 of the stepped care model of depression?

Answer 5

Recognition of symptoms through screening questions

Question 6

What are the symptoms of depression from CGASPDIE?

Answer 6

Concentration difficulties
Guilt
Appetite changes
Sleep disturbance
Psychomotor retardation
Death or suicide ideas
Interest loss
Energy loss

Question 7

What is step 2 of the stepped care model of depression?

Answer 7

Mild:

Computerised CBT
Watchful waiting
Self help
Counselling

Question 8

What is step 3 of the stepped care model of depression?

Answer 8

Moderate:

SSRI
CBT or IPT
Combination if severe

Question 9

What SSRIs do NICE recommend?

Answer 9

Citalopram and fluoxetine

Sertraline if CV disease

Question 10

For moderate depression, describe the therapy regime recommended:

Answer 10

16-20 session over 6-9 months

Question 11

How should chronic depression be treated?

Answer 11

Combined CBT and antidepressant

Rehab if unemployed or socially isolated

Question 12

What is step 4 of the stepped care model of depression?

Answer 12

Treatment resistant or recurrent:

Combination of CBT and antidepressants
Lithium
Venlafaxine

Question 13

What is step 5 of the stepped care model of depression?

Answer 13

Risk to life:

ECT