Depression and anxiety: biopsychosocial assessment at diagnosis
Indicator
The percentage of patients with a new diagnosis of depression in the preceding 1 April to 31 March who have had a bio-psychosocial assessment by the point of diagnosis.
Indicator type
General practice indicator suitable for use in the Quality and Outcomes Framework.
This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.
To find out how to use indicators and how we develop them, see our NICE indicator process guide.
Rationale
People with suspected depression should have a comprehensive assessment which includes severity of symptoms, previous history, duration and course of illness. It should also take into account the degree of functional impairment and/or disability associated with the possible depression, and duration of the episode.
A bio-psychosocial assessment is a qualitative assessment of a person presenting with suspected depression which considers physical, psychological and social aspects of the condition. This assessment must be recorded as completed on the same date as the diagnosis of depression is made. This assessment should follow good clinical practice and should address the following:
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Current symptoms including duration and severity.
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Personal history of depression and coexisting mental health or physical disorders.
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Any history of mood elevation.
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Family history of mental illness.
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Personal strengths and resources, including supportive relationships.
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Difficulties with previous and current interpersonal relationships.
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Current lifestyle (for example, diet, physical activity, sleep).
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Any recent or past experience of stressful or traumatic life events, such as redundancy, divorce, bereavement, trauma.
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Living conditions.
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Social isolation.
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Employment situation.
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Debt.
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Current or previous alcohol and drug use (prescribed or illicit).
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Suicidal ideation.
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Discussion of treatment options.
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Any past experience of, and response to, treatments.
Source guidance
Depression in adults. NICE guideline NG222 (2022), recommendations 1.2.6 and 1.2.7
Specification
Numerator: The number of patients in the denominator who have had a bio-psychosocial assessment by the point of diagnosis.
Denominator: The number of patients with a new diagnosis of depression in the preceding 1 April to 31 March.
Calculation: Numerator divided by the denominator, multiplied by 100.
Exclusions: None
Minimum population: The indicator would be appropriate to assess performance at individual general practice level.
ISBN: 978-1-4731-6062-0