Depression Care Standard 37: Specialist assessment and treatment is available for service users with treatment-resistant, recurrent and chronic depression.
Supporting material for standard 37:
Specialist assessment and treatment should be available for service users with treatment resistant, recurrent and chronic depression.
There are specific evidence-based interventions, eg electroconvulsive therapy (ECT), mood stabilisers, antipsychotics and longer term psychological therapy, which may be of considerable benefit when prescribed for the right individuals. These may have to be continued in the long term in a stable, supportive therapeutic relationship.
Examples of evidence required to meet standard 37:
- local algorithm which includes options for those who appear to be resistant to treatment
Useful Resources:
- 1. NHS Connecting for Health. Do once and share: depression care pathway: mapping a solution. 2006, pages 14-20
- 2. NICE. Depression: management of depression in primary and secondary care. London:NICE; 2004 NICE clinical guideline 23, pages 52, 64-69, 111-113 and 239-259
- 3. The Royal College of Psychiatrists. The ECT Handbook (Second edition), (Third Report of the Royal College of Psychiatrists’ Special Committee on ECT). Edited by Allan Scott. London:Royal College of Psychiatrists; 2005
Chapter 2: The use of ECT in depressive illness - Heinrich C. Lamprecht, I. Nicol Ferrier and Alan G. Swann.
Chapter 11: Systematic review. Continuation pharmacotherapy after ECT for depressive illness - Andrew M. McIntosh and Stephen M. Lawrie.
- 4. Enid M Hunkeler, Wayne Katon, Lingqi Tang, John W Williams, Jr, Kurt Kroenke, Elizabeth H B Lin, Linda H Harpole, Patricia Arean, Stuart Levine, Lydia M Grypma, William A Hargreaves, Jurgen Unutzer. Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. BMJ 2006; 332: 259-263.