Depression in Adults: Treatment and Management ( Summary NICE Guidance 2022 )

In June 2022, NICE updated its guideline on the diagnosis and management of depression, providing new recommendations highly relevant to primary care. This update emphasizes the importance of shared decision-making, respect for patient autonomy, and careful consideration of mental capacity and medicines management. Health and social care professionals are reminded to adhere to NICE’s broader standards for safe and effective care delivery, including in areas such as medicines adherence, multimorbidity, and service user experience in mental health.

The guideline also introduces a revised approach to defining depression severity, recognizing it as a continuum influenced by symptom intensity, duration, and functional impact. Rather than the traditional four categories (subthreshold, mild, moderate, and severe), depression is now classified more simply as "less severe" (subthreshold and mild) or "more severe" (moderate and severe). Validated scales, such as the PHQ-9, are recommended for assessing severity, with a threshold score of 16 distinguishing between less and more severe depression.