Guidance
This guideline covers identifying, treating and managing depression in people aged 18 and over who also have a chronic physical health problem such as cancer, heart disease or diabetes. It aims to improve the care of people with a long-term physical health problem, which can cause or exacerbate depression. This has the potential to increase their quality of life and life expectancy.
NICE has also produced a guideline on depression in adults: treatment and management.
Last reviewed: 15 May 2024
We simplified the guideline by removing recommendations on general principles of care that are covered in other NICE guidelines (for example, the NICE guideline on service user experience in adult mental health). This is a presentational change only, and no changes to practice are intended.
This guideline updates recommendations made in NICE technology appraisal guidance 97 for the treatment of depression only.
Next review: This guidance will be reviewed if there is new evidence that is likely to change the recommendations.
Recommendations
This guideline includes recommendations on:
- care of all people with depression
- stepped care
- recognition, assessment and initial management
- persistent subthreshold depressive symptoms or mild to moderate depression
- persistent subthreshold depressive symptoms, mild to moderate depression with inadequate response to initial interventions or moderate and severe depression
- complex and severe depression
Who is it for?
- Healthcare professionals
- Adults with depression and a chronic physical health problem, and their families and carers
Guideline development process
How we develop NICE guidelines
This guideline was previously called depression in adults with chronic physical health problem: treatment and management.
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.