This guideline has been developed to advise on the identification and management of depression in children and young people in primary, community and secondary care. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, carers, and guideline methodologists after careful consideration of the best available evidence. It is intended that the guidelines will be useful to clinicians and service commissioners in providing and planning high-quality care for children and young people with depression while also emphasising the importance of the experience of care for patients and their families.

Contents

• Guideline Development Group Membership
• Acknowledgements
• 1. Introduction
  • 1.1. National guidelines
  • 1.2. The national Depression in Children and Young People guideline
• 2. Methods used to develop this guideline
  • 2.1. Overview
  • 2.2. The Guideline Development Group
  • 2.3. Clinical questions
  • 2.4. Systematic clinical literature review
  • 2.5. Health economics review
  • 2.6. Stakeholder contributions
  • 2.7. Validation of this guideline
• 3. Depression
  • 3.1. The disorder
  • 3.2. Prevalence
  • 3.3. Diagnosis
  • 3.4. Aetiology
  • 3.5. Use of health service resources and other costs
  • 3.6. Treatment and management in the NHS
  • 3.7. Black and minority ethnic groups
  • 3.8. Clinical practice recommendations
• 4. Screening and risk factors
  • 4.1. Introduction
  • 4.2. Screening instruments
  • 4.3. Risk factors
  • 4.4. Clinical recommendations
• 5. Self-help, family support/parental education and social/environmental interventions
  • 5.1. Self-help
  • 5.2. Family support/parental education
  • 5.3. Social/environmental interventions
  • 5.4. Clinical practice recommendations
• 6. Psychological treatment of depression in children and young people
  • 6.1. Introduction
  • 6.2. Psychological therapies
  • 6.3. Association between primary outcomes and characteristics of therapist/patient
  • 6.4. Relapse prevention
  • 6.5. Clinical practice recommendations
• 7. Pharmacological and physical treatment of depression in children and young people
  • 7.1. Introduction
  • 7.2. Prescribing for children and young people
  • 7.3. The Regulatory Framework
  • 7.4. Antidepressant drugs
  • 7.5. Antidepressant drug versus psychological therapies, and the combination
  • 7.6. Other drug treatment
  • 7.7. Relapse prevention
  • 7.8. Electroconvulsive therapy (ECT)
  • 7.9. Psychotic depression
  • 7.10. Clinical practice recommendations
• 8. Service configurations
  • 8.1. Implications for service configuration
  • 8.2. Inpatient units in the treatment of depression
  • 8.3. Clinical practice recommendations
• 9. Summary of recommendations
  • 9.1. Key recommendations for implementation
  • 9.2. Guidance
  • 9.3. Care of all children and young people with depression
  • 9.4. Stepped care
  • 9.5. Step 1: Detection, risk profiling and referral
  • 9.6. Step 2: Recognition
  • 9.7. Step 3: Mild depression
  • 9.8. Steps 4 and 5: Moderate to severe depression
  • 9.9. Transfer to adult services
  • 9.10. Research recommendations
  • 9.11. Audit criteria
• 10. Appendices
  • Appendix A. Scope for the development of a clinical guideline on the identification and management of depression in children and young people
  • Appendix B. Stakeholders who responded to early requests for evidence
  • Appendix C. Stakeholders and experts who responded to the first consultation draft of the guideline
  • Appendix D. Researchers/companies contacted to request information about unpublished or soon-to-be published studies
  • Appendix E. Clinical questions
  • Appendix F. Search strategies for the identification of clinical studies
  • Appendix G. Systematic review quality checklist
  • Appendix H. RCT methodological quality checklist
  • Appendix I. Clinical study data extraction form
  • Appendix J. Self-rated and interviewer-based instruments used for screening for depression
  • Appendix K. Common forms of self-help
  • Appendix L. Self-help resources
  • Appendix M. Health economics search results
  • Appendix N. Quality checklists for economic studies
  • Appendix O. Four Tier Strategic Framework
  • Appendix P. Evidence profile tables
  • Appendix Q. Family support/ parental education - Included and excluded studies
  • Appendix R. Psychological interventions - Included and excluded studies
  • Appendix S. Antidepressant drug treatment - Included and excluded studies
  • Appendix T. Other drug treatment - Included and excluded studies
  • Appendix U. Psychological intervention-forest plots
  • Appendix V. Antidepressant drug treatment – forest plots
• 11. References
• 12. Abbreviations
• 13. Glossary

The views presented in this book do not necessarily reflect those of the British Psychological Society, and the publishers are not responsible for any error of omission or fact. The British Psychological Society is a registered charity (no. 229642).