Quality statement 13: Residual symptoms or risk of relapse

Quality statement

People who have been treated for depression who have residual symptoms or are considered to be at significant risk of relapse receive appropriate psychological interventions.

Quality measure

Structure: Evidence of local arrangements to provide appropriate psychological interventions to people who have been treated for depression who have residual symptoms or are at significant risk of relapse.

Process: Proportion of people who have been treated for depression who have residual symptoms or are at significant risk of relapse who receive appropriate psychological interventions.

Numerator – the number of people in the denominator receiving appropriate psychological interventions.

Denominator – the number of people who have been treated for depression who have residual symptoms or are at significant risk of relapse.

What the quality statement means for each audience

Service providers ensure systems are in place to provide appropriate psychological interventions for people who have been treated for depression who have residual symptoms or are considered to be at significant risk of relapse.

Healthcare professionals ensure people who have been treated for depression who have residual symptoms or are considered to be at significant risk of relapse receive appropriate psychological interventions.

Commissioners ensure they commission services that provide appropriate psychological interventions for people who have been treated for depression who have residual symptoms or are considered to be at significant risk of relapse.

People who have been treated for depression who have remaining symptoms or whose symptoms are likely to return receive further suitable psychological treatment.

Definitions

The term 'people who have been treated for depression' includes all people with a chronic physical health problem who have been treated for depression.

The term 'at significant risk of relapse' includes those who have relapsed despite antidepressant treatment or who are unable or choose not to continue antidepressant treatment.

People with depression are at risk of relapse if:

  • they have had two or more episodes of depression in the recent past, during which they experienced significant functional impairment

  • they have other risk factors for relapse such as residual symptoms, multiple previous episodes, or a history of severe or prolonged episodes or of inadequate response

Appropriate psychological interventions for people at significant risk of relapse are:

  • individual cognitive behavioural therapy for people who have relapsed despite antidepressant medication and for people with a significant history of depression and residual symptoms despite treatment

  • mindfulness-based cognitive therapy for people who are currently well but have experienced three or more previous episodes of depression.

Source guidance

NICE clinical guideline 90 recommendation 1.9.1.8 (key priority for implementation).

Data source

Structure: Local data collection.

Process: Local data collection.