Scottish Intercollegiate Guidelines Network (SIGN)

BACKGROUND

Depression is a significant health problem which affects men and women of all ages and social backgrounds.The personal, social and economic consequences are substantial.

Depression is associated with sickness absence and prevents many people seeking, maintaining or returning to employment. Prescribed antidepressant medication is the most common treatment.

WHY WE NEED A GUIDELINE

Depression Alliance Scotland proposed the development of this guideline based on feedback from service users who were seeking information about interventions other than prescribed antidepressants which could be helpful in managing their depression.

The Scottish Integrated Care Pathway (ICP) for depression sets standards for appropriate care and treatment of people with depression. It states that for those who choose a non-pharmacological approach, or for whom medication is not effective, there should be the offer of a brief depressionfocused psychological intervention.

There is a need for accessible and robust evidence based information about the alternatives to prescribed antidepressants to be available to both GPs and service users.

REMIT

This guideline provides an assessment of, and presents the evidence base for, the efficacy of non-pharmaceutical therapies, encompassing psychological therapies, structured exercise and lifestyle interventions, and a range of alternative and complementary treatments, many of which are not routinely available within the NHS.

TARGET USERS OF THE GUIDELINE

This guideline will be of particular interest to those developing mental health services, health care professionals in primary and secondary care (eg GPs, community psychiatric nurses, clinical psychologists and psychiatrists) and patients with depression and their carers.

It may also be helpful to voluntary organisations and exercise professionals working in exercise referral schemes, public or private fitness centres, and physical activity promotion.