🕷️ Crawler Inspector

URL Lookup

Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 57 (from laksa137)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa057.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.nice.org.uk/guidance/ng222\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.nice.org.uk/guidance/ng222\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.nice.org.uk\/guidance\/ng222","crawl_time":1775526171,"first_indexed_time":1656461404,"http_code":200,"src_unparsed":"uk,org,nice!www,\/guidance\/ng222 s443","src_root_hash":"2740109274380393857","history_drop_reason":null,"meta_title":"Overview | Depression in adults: treatment and management | Guidance | NICE","meta_descriptions":["This guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder"],"attrs_boilerpipe_text":"This guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder.\nNICE has also produced a\nguideline on depression in adults with a chronic physical health problem\n.\nLast reviewed:\n30 January 2026\nWe reviewed this guideline and will not update the recommendations. See the \nsurveillance decision\n for further details.\nThis guideline updates and replaces NICE guideline CG90 (October 2009).\nNext review:\nThis guideline will be reviewed if there is new evidence that is likely to change the recommendations.\nHow we prioritise updating our guidance\nDecisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see \nNICE-wide topic prioritisation: the manual\n.\nFor information about individual topics, including any decisions affecting this guideline, see the \nsummary table of prioritisation board decisions\n.\nRecommendations\nThis guideline includes recommendations on:\nprinciples of care\nrecognition and assessment\nchoice\nand\ndelivery of treatments\ntreatment for a new episode of less severe depression\ntreatment for a new episode of more severe depression\nbehavioural couples therapy\npreventing relapse\nfurther-line treatment\nchronic depressive symptoms\ndepression in people with a diagnosis of personality disorder\npsychotic depression\nelectroconvulsive therapy\n,\ntranscranial magnetic stimulation\nand\ntreatment-resistant depression\naccess, coordination and delivery of care\n.\nSee visual summaries on the recommendations for:\ndiscussing first-line treatments for less severe depression\ndiscussing first-line treatments for more severe depression\npreventing relapse\nfurther-line treatment\ntreatment options for chronic depression, depression with personality disorder or psychotic depression\nthe matched care model\nWho is it for?\nHealthcare professionals\nOther professionals who have direct contact with, or provide health and other public services for, people with depression\nCommissioners and providers of services for people with depression\nPeople with depression, their families and carers\nGuideline development process\nHow we develop NICE guidelines\nThis guideline was previously called depression in adults: recognition and management.\nYour responsibility\nThe recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.\nAll problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the\nYellow Card Scheme\n.\nLocal commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.\nCommissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should\nassess and reduce the environmental impact of implementing NICE recommendations\nwherever possible.","attrs_markdown":"- [Skip to content](https:\/\/www.nice.org.uk\/guidance\/ng222#content-start)\n- [Accessibility help](https:\/\/www.nice.org.uk\/accessibility)\n\nMenu\n\n[Sign in](https:\/\/accounts.nice.org.uk\/signin)\n\n- [Guidance](https:\/\/www.nice.org.uk\/guidance)\n- [Standards and indicators](https:\/\/www.nice.org.uk\/standards-and-indicators)\n- [Clinical Knowledge Summaries (CKS)](https:\/\/cks.nice.org.uk\/)\n- [British National Formulary (BNF)](https:\/\/bnf.nice.org.uk\/)\n- [BNF for Children (BNFC)](https:\/\/bnfc.nice.org.uk\/)\n- [Life sciences](https:\/\/www.nice.org.uk\/about\/what-we-do\/life-sciences)\n- More from NICE\n  [Skip More from NICE submenu](https:\/\/www.nice.org.uk\/guidance\/ng222#content-start)\n  \n  ## Explore more from NICE\n  - [What NICE does](https:\/\/www.nice.org.uk\/what-nice-does)\n  - [About us](https:\/\/www.nice.org.uk\/about-us)\n  - [Reusing our content](https:\/\/www.nice.org.uk\/reusing-our-content)\n  - [Implementing NICE guidance](https:\/\/www.nice.org.uk\/implementing-nice-guidance)\n  - [News, blogs and podcasts](https:\/\/www.nice.org.uk\/news)\n  - [Contact us](https:\/\/www.nice.org.uk\/contact-us)\n  - [Get involved](https:\/\/www.nice.org.uk\/get-involved)\n  - [Careers](https:\/\/www.nice.org.uk\/careers)\n  ***\n  - [Join a committee](https:\/\/www.nice.org.uk\/get-involved\/our-committees)\n  - [Comment on a consultation](https:\/\/www.nice.org.uk\/get-involved\/consultations)\n  \n  Close menu\n\n## My account\n- [Consultation responses](https:\/\/www.nice.org.uk\/consultations\/)\n- [Sign in](https:\/\/accounts.nice.org.uk\/signin)\n\nYou are here:\n\n1. [Home](https:\/\/www.nice.org.uk\/)\n2. [NICE Guidance](https:\/\/www.nice.org.uk\/guidance)\n3. [Conditions and diseases](https:\/\/www.nice.org.uk\/guidance\/conditions-and-diseases)\n4. [Mental health, behavioural and neurodevelopmental conditions](https:\/\/www.nice.org.uk\/guidance\/conditions-and-diseases\/mental-health-behavioural-and-neurodevelopmental-conditions)\n5. [Depression](https:\/\/www.nice.org.uk\/guidance\/conditions-and-diseases\/mental-health-behavioural-and-neurodevelopmental-conditions\/depression)\n\n# Depression in adults: treatment and management\n- NICE guideline\n- Reference number: NG222\n- Published:\n  29 June 2022\n\n[Register as a stakeholder](https:\/\/www.nice.org.uk\/get-involved\/register-your-organisation-as-a-stakeholder)\n\n- [Guidance](https:\/\/www.nice.org.uk\/guidance\/ng222)\n- [Tools and resources](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources)\n- [Information for the public](https:\/\/www.nice.org.uk\/guidance\/ng222\/informationforpublic)\n- [Evidence](https:\/\/www.nice.org.uk\/guidance\/ng222\/evidence)\n- [History](https:\/\/www.nice.org.uk\/guidance\/ng222\/history)\n\n[Download guidance (PDF)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/depression-in-adults-treatment-and-management-pdf-66143832307909)\n\n- [Overview](https:\/\/www.nice.org.uk\/guidance\/ng222)\n- [Recommendations](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations)\n- [Recommendations for research](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations-for-research)\n- [Rationale and impact](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Rationale-and-impact)\n- [Context](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Context)\n- [Finding more information and committee details](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Finding-more-information-and-committee-details)\n- [Update information](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Update-information)\n\n## Overview\nThis guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder.\n\nNICE has also produced a [guideline on depression in adults with a chronic physical health problem](http:\/\/www.nice.org.uk\/guidance\/CG91).\n\n**Last reviewed:** 30 January 2026\n\nWe reviewed this guideline and will not update the recommendations. See the [surveillance decision](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/january-2026-exceptional-surveillance-of-depression-in-adults-treatment-and-management-nice-15604053806\/chapter\/surveillance-proposal?tab=evidence) for further details.\n\nThis guideline updates and replaces NICE guideline CG90 (October 2009).\n\n**Next review:** This guideline will be reviewed if there is new evidence that is likely to change the recommendations.\n\n**How we prioritise updating our guidance**\n\nDecisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see [NICE-wide topic prioritisation: the manual](https:\/\/www.nice.org.uk\/process\/pmg46 \"https:\/\/www.nice.org.uk\/process\/pmg46\").\n\nFor information about individual topics, including any decisions affecting this guideline, see the [summary table of prioritisation board decisions](https:\/\/www.nice.org.uk\/about\/what-we-do\/prioritising-our-guidance-topics\/our-prioritisation-decisions \"https:\/\/www.nice.org.uk\/about\/what-we-do\/prioritising-our-guidance-topics\/our-prioritisation-decisions\").\n\n### Recommendations\nThis guideline includes recommendations on:\n\n- [principles of care](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#principles-of-care)\n- [recognition and assessment](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#recognition-and-assessment)\n- [choice](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#choice-of-treatments) and [delivery of treatments](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#delivery-of-treatments)\n- [treatment for a new episode of less severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#treatment-for-a-new-episode-of-less-severe-depression)\n- [treatment for a new episode of more severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#treatment-for-a-new-episode-of-more-severe-depression)\n- [behavioural couples therapy](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#behavioural-couples-therapy-for-depression)\n- [preventing relapse](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#preventing-relapse)\n- [further-line treatment](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#further-line-treatment)\n- [chronic depressive symptoms](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#chronic-depressive-symptoms)\n- [depression in people with a diagnosis of personality disorder](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#depression-in-people-with-a-diagnosis-of-personality-disorder)\n- [psychotic depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#psychotic-depression)\n- [electroconvulsive therapy](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#electroconvulsive-therapy-for-depression), [transcranial magnetic stimulation](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#transcranial-magnetic-stimulation-for-depression) and [treatment-resistant depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#treatment-resistant-depression)\n- [access, coordination and delivery of care](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#access-coordination-and-delivery-of-care).\n##### See visual summaries on the recommendations for:\n- [discussing first-line treatments for less severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006)\n- [discussing first-line treatments for more severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007)\n- [preventing relapse](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/preventing-relapse-pdf-11131007008)\n- [further-line treatment](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/furtherline-treatment-pdf-11131007009)\n- [treatment options for chronic depression, depression with personality disorder or psychotic depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010)\n- [the matched care model](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/the-matched-care-model-pdf-11131007011)\n\n[![View visual summary 1](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-1.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006) [![View visual summary 2](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-2.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007)[![View visual summary 3](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-3.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/preventing-relapse-pdf-11131007008) [![View visual summary 4](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-4.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/furtherline-treatment-pdf-11131007009)[![View visual summary 5](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-5.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010)[![View visual summary 6](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-6.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/the-matched-care-model-pdf-11131007011)\n\n### Who is it for?\n- Healthcare professionals\n- Other professionals who have direct contact with, or provide health and other public services for, people with depression\n- Commissioners and providers of services for people with depression\n- People with depression, their families and carers\n### Guideline development process\n[How we develop NICE guidelines](https:\/\/www.nice.org.uk\/about\/what-we-do\/our-programmes\/nice-guidance\/nice-guidelines\/how-we-develop-nice-guidelines)\n\nThis guideline was previously called depression in adults: recognition and management.\n\n#### Your responsibility\nThe recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.\n\nAll problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the [Yellow Card Scheme](https:\/\/www.gov.uk\/report-problem-medicine-medical-device).\n\nLocal commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.\n\nCommissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should [assess and reduce the environmental impact of implementing NICE recommendations](https:\/\/www.nice.org.uk\/about\/who-we-are\/sustainability) wherever possible.\n\n### Related quality standards\n[Depression in adults](https:\/\/www.nice.org.uk\/guidance\/qs8)\n\n***\n[Next page Recommendations](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations)\n\n[Back to top](https:\/\/www.nice.org.uk\/guidance\/ng222#top)\n\n- [Guidance](https:\/\/www.nice.org.uk\/guidance)\n- [Standards and indicators](https:\/\/www.nice.org.uk\/standards-and-indicators)\n- [Clinical Knowledge Summaries (CKS) Clinical Knowledge SummariesClinical Knowledge Summaries](https:\/\/cks.nice.org.uk\/)\n- [British National Formulary (BNF) British National FormularyBritish National Formulary](https:\/\/bnf.nice.org.uk\/)\n- [BNF for Children (BNFC) British National Formulary for ChildrenBritish National Formulary for Children](https:\/\/bnfc.nice.org.uk\/)\n- [Life sciences](https:\/\/www.nice.org.uk\/about\/what-we-do\/life-sciences)\n- [Library and knowledge services](https:\/\/www.nice.org.uk\/library-and-knowledge-services)\n\n- [What NICE does](https:\/\/www.nice.org.uk\/what-nice-does)\n- [Implementing NICE guidance](https:\/\/www.nice.org.uk\/implementing-nice-guidance)\n- [Get involved](https:\/\/www.nice.org.uk\/get-involved)\n- [About us](https:\/\/www.nice.org.uk\/about-us)\n- [Careers](https:\/\/www.nice.org.uk\/careers)\n- [News, blogs and podcasts](https:\/\/www.nice.org.uk\/news)\n- [Newsletters and alerts](https:\/\/www.nice.org.uk\/nice-newsletters-and-alerts)\n- [Contact us](https:\/\/www.nice.org.uk\/contact-us)\n- [Leave feedback](https:\/\/www.nice.org.uk\/forms\/leave-feedback)\n- [Reusing our content](https:\/\/www.nice.org.uk\/reusing-our-content)\n- [NICE UK Open Content Licence](https:\/\/www.nice.org.uk\/forms\/use-of-nice-content-in-the-uk)\n- [Syndicate our content](https:\/\/www.nice.org.uk\/about\/what-we-do\/nice-syndication-api)\n- [Events](https:\/\/www.nice.org.uk\/events)\n\n- [Facebook](https:\/\/en-gb.facebook.com\/NationalInstituteforHealthandCareExcellence\/)\n- [X](https:\/\/x.com\/NICEcomms)\n- [YouTube](https:\/\/www.youtube.com\/user\/NICEmedia)\n- [LinkedIn](https:\/\/www.linkedin.com\/company\/national-institute-for-health-and-clinical-excellence)\n\n- [Accessibility](https:\/\/www.nice.org.uk\/accessibility)\n- [Freedom of information](https:\/\/www.nice.org.uk\/freedom-of-information)\n- [Glossary](https:\/\/www.nice.org.uk\/glossary)\n- [Terms and conditions](https:\/\/www.nice.org.uk\/terms-and-conditions)\n- [Privacy notice](https:\/\/www.nice.org.uk\/privacy-notice)\n- [Cookies](https:\/\/www.nice.org.uk\/cookies)\n\n© NICE 2026. All rights reserved. Subject to [Notice of rights](https:\/\/www.nice.org.uk\/terms-and-conditions#notice-of-rights).","attrs_readable_markdown":"This guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder.\n\nNICE has also produced a [guideline on depression in adults with a chronic physical health problem](http:\/\/www.nice.org.uk\/guidance\/CG91).\n\n**Last reviewed:** 30 January 2026\n\nWe reviewed this guideline and will not update the recommendations. See the [surveillance decision](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/january-2026-exceptional-surveillance-of-depression-in-adults-treatment-and-management-nice-15604053806\/chapter\/surveillance-proposal?tab=evidence) for further details.\n\nThis guideline updates and replaces NICE guideline CG90 (October 2009).\n\n**Next review:** This guideline will be reviewed if there is new evidence that is likely to change the recommendations.\n\n**How we prioritise updating our guidance**\n\nDecisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see [NICE-wide topic prioritisation: the manual](https:\/\/www.nice.org.uk\/process\/pmg46 \"https:\/\/www.nice.org.uk\/process\/pmg46\").\n\nFor information about individual topics, including any decisions affecting this guideline, see the [summary table of prioritisation board decisions](https:\/\/www.nice.org.uk\/about\/what-we-do\/prioritising-our-guidance-topics\/our-prioritisation-decisions \"https:\/\/www.nice.org.uk\/about\/what-we-do\/prioritising-our-guidance-topics\/our-prioritisation-decisions\").\n\n### Recommendations\nThis guideline includes recommendations on:\n\n- [principles of care](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#principles-of-care)\n- [recognition and assessment](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#recognition-and-assessment)\n- [choice](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#choice-of-treatments) and [delivery of treatments](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#delivery-of-treatments)\n- [treatment for a new episode of less severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#treatment-for-a-new-episode-of-less-severe-depression)\n- [treatment for a new episode of more severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#treatment-for-a-new-episode-of-more-severe-depression)\n- [behavioural couples therapy](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#behavioural-couples-therapy-for-depression)\n- [preventing relapse](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#preventing-relapse)\n- [further-line treatment](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#further-line-treatment)\n- [chronic depressive symptoms](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#chronic-depressive-symptoms)\n- [depression in people with a diagnosis of personality disorder](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#depression-in-people-with-a-diagnosis-of-personality-disorder)\n- [psychotic depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#psychotic-depression)\n- [electroconvulsive therapy](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#electroconvulsive-therapy-for-depression), [transcranial magnetic stimulation](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#transcranial-magnetic-stimulation-for-depression) and [treatment-resistant depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#treatment-resistant-depression)\n- [access, coordination and delivery of care](https:\/\/www.nice.org.uk\/guidance\/ng222\/chapter\/Recommendations#access-coordination-and-delivery-of-care).\n##### See visual summaries on the recommendations for:\n- [discussing first-line treatments for less severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006)\n- [discussing first-line treatments for more severe depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007)\n- [preventing relapse](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/preventing-relapse-pdf-11131007008)\n- [further-line treatment](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/furtherline-treatment-pdf-11131007009)\n- [treatment options for chronic depression, depression with personality disorder or psychotic depression](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010)\n- [the matched care model](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/the-matched-care-model-pdf-11131007011)\n\n[![View visual summary 1](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-1.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006) [![View visual summary 2](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-2.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007)[![View visual summary 3](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-3.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/preventing-relapse-pdf-11131007008) [![View visual summary 4](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-4.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/furtherline-treatment-pdf-11131007009)[![View visual summary 5](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-5.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010)[![View visual summary 6](https:\/\/www.nice.org.uk\/Media\/Default\/guidance\/NG222-6.PNG)](https:\/\/www.nice.org.uk\/guidance\/ng222\/resources\/the-matched-care-model-pdf-11131007011)\n\n### Who is it for?\n- Healthcare professionals\n- Other professionals who have direct contact with, or provide health and other public services for, people with depression\n- Commissioners and providers of services for people with depression\n- People with depression, their families and carers\n### Guideline development process\n[How we develop NICE guidelines](https:\/\/www.nice.org.uk\/about\/what-we-do\/our-programmes\/nice-guidance\/nice-guidelines\/how-we-develop-nice-guidelines)\n\nThis guideline was previously called depression in adults: recognition and management.\n\n#### Your responsibility\nThe recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.\n\nAll problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the [Yellow Card Scheme](https:\/\/www.gov.uk\/report-problem-medicine-medical-device).\n\nLocal commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.\n\nCommissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should [assess and reduce the environmental impact of implementing NICE recommendations](https:\/\/www.nice.org.uk\/about\/who-we-are\/sustainability) wherever possible.","meta_canonical":null}

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URL	https://www.nice.org.uk/guidance/ng222
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Meta Title	Overview \| Depression in adults: treatment and management \| Guidance \| NICE
Meta Description	This guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder
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Boilerpipe Text	This guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder. NICE has also produced a guideline on depression in adults with a chronic physical health problem . Last reviewed: 30 January 2026 We reviewed this guideline and will not update the recommendations. See the surveillance decision for further details. This guideline updates and replaces NICE guideline CG90 (October 2009). Next review: This guideline will be reviewed if there is new evidence that is likely to change the recommendations. How we prioritise updating our guidance Decisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see NICE-wide topic prioritisation: the manual . For information about individual topics, including any decisions affecting this guideline, see the summary table of prioritisation board decisions . Recommendations This guideline includes recommendations on: principles of care recognition and assessment choice and delivery of treatments treatment for a new episode of less severe depression treatment for a new episode of more severe depression behavioural couples therapy preventing relapse further-line treatment chronic depressive symptoms depression in people with a diagnosis of personality disorder psychotic depression electroconvulsive therapy , transcranial magnetic stimulation and treatment-resistant depression access, coordination and delivery of care . See visual summaries on the recommendations for: discussing first-line treatments for less severe depression discussing first-line treatments for more severe depression preventing relapse further-line treatment treatment options for chronic depression, depression with personality disorder or psychotic depression the matched care model Who is it for? Healthcare professionals Other professionals who have direct contact with, or provide health and other public services for, people with depression Commissioners and providers of services for people with depression People with depression, their families and carers Guideline development process How we develop NICE guidelines This guideline was previously called depression in adults: recognition and management. Your responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme . Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.
Markdown	- [Skip to content](https://www.nice.org.uk/guidance/ng222#content-start) - [Accessibility help](https://www.nice.org.uk/accessibility) Menu [Sign in](https://accounts.nice.org.uk/signin) - [Guidance](https://www.nice.org.uk/guidance) - [Standards and indicators](https://www.nice.org.uk/standards-and-indicators) - [Clinical Knowledge Summaries (CKS)](https://cks.nice.org.uk/) - [British National Formulary (BNF)](https://bnf.nice.org.uk/) - [BNF for Children (BNFC)](https://bnfc.nice.org.uk/) - [Life sciences](https://www.nice.org.uk/about/what-we-do/life-sciences) - More from NICE [Skip More from NICE submenu](https://www.nice.org.uk/guidance/ng222#content-start) ## Explore more from NICE - [What NICE does](https://www.nice.org.uk/what-nice-does) - [About us](https://www.nice.org.uk/about-us) - [Reusing our content](https://www.nice.org.uk/reusing-our-content) - [Implementing NICE guidance](https://www.nice.org.uk/implementing-nice-guidance) - [News, blogs and podcasts](https://www.nice.org.uk/news) - [Contact us](https://www.nice.org.uk/contact-us) - [Get involved](https://www.nice.org.uk/get-involved) - [Careers](https://www.nice.org.uk/careers) * - [Join a committee](https://www.nice.org.uk/get-involved/our-committees) - [Comment on a consultation](https://www.nice.org.uk/get-involved/consultations) Close menu ## My account - [Consultation responses](https://www.nice.org.uk/consultations/) - [Sign in](https://accounts.nice.org.uk/signin) You are here: 1. [Home](https://www.nice.org.uk/) 2. [NICE Guidance](https://www.nice.org.uk/guidance) 3. [Conditions and diseases](https://www.nice.org.uk/guidance/conditions-and-diseases) 4. [Mental health, behavioural and neurodevelopmental conditions](https://www.nice.org.uk/guidance/conditions-and-diseases/mental-health-behavioural-and-neurodevelopmental-conditions) 5. [Depression](https://www.nice.org.uk/guidance/conditions-and-diseases/mental-health-behavioural-and-neurodevelopmental-conditions/depression) # Depression in adults: treatment and management - NICE guideline - Reference number: NG222 - Published: 29 June 2022 [Register as a stakeholder](https://www.nice.org.uk/get-involved/register-your-organisation-as-a-stakeholder) - [Guidance](https://www.nice.org.uk/guidance/ng222) - [Tools and resources](https://www.nice.org.uk/guidance/ng222/resources) - [Information for the public](https://www.nice.org.uk/guidance/ng222/informationforpublic) - [Evidence](https://www.nice.org.uk/guidance/ng222/evidence) - [History](https://www.nice.org.uk/guidance/ng222/history) [Download guidance (PDF)](https://www.nice.org.uk/guidance/ng222/resources/depression-in-adults-treatment-and-management-pdf-66143832307909) - [Overview](https://www.nice.org.uk/guidance/ng222) - [Recommendations](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations) - [Recommendations for research](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations-for-research) - [Rationale and impact](https://www.nice.org.uk/guidance/ng222/chapter/Rationale-and-impact) - [Context](https://www.nice.org.uk/guidance/ng222/chapter/Context) - [Finding more information and committee details](https://www.nice.org.uk/guidance/ng222/chapter/Finding-more-information-and-committee-details) - [Update information](https://www.nice.org.uk/guidance/ng222/chapter/Update-information) ## Overview This guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder. NICE has also produced a [guideline on depression in adults with a chronic physical health problem](http://www.nice.org.uk/guidance/CG91). Last reviewed: 30 January 2026 We reviewed this guideline and will not update the recommendations. See the [surveillance decision](https://www.nice.org.uk/guidance/ng222/resources/january-2026-exceptional-surveillance-of-depression-in-adults-treatment-and-management-nice-15604053806/chapter/surveillance-proposal?tab=evidence) for further details. This guideline updates and replaces NICE guideline CG90 (October 2009). Next review: This guideline will be reviewed if there is new evidence that is likely to change the recommendations. How we prioritise updating our guidance Decisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see [NICE-wide topic prioritisation: the manual](https://www.nice.org.uk/process/pmg46 "https://www.nice.org.uk/process/pmg46"). For information about individual topics, including any decisions affecting this guideline, see the [summary table of prioritisation board decisions](https://www.nice.org.uk/about/what-we-do/prioritising-our-guidance-topics/our-prioritisation-decisions "https://www.nice.org.uk/about/what-we-do/prioritising-our-guidance-topics/our-prioritisation-decisions"). ### Recommendations This guideline includes recommendations on: - [principles of care](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#principles-of-care) - [recognition and assessment](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#recognition-and-assessment) - [choice](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#choice-of-treatments) and [delivery of treatments](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#delivery-of-treatments) - [treatment for a new episode of less severe depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#treatment-for-a-new-episode-of-less-severe-depression) - [treatment for a new episode of more severe depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#treatment-for-a-new-episode-of-more-severe-depression) - [behavioural couples therapy](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#behavioural-couples-therapy-for-depression) - [preventing relapse](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#preventing-relapse) - [further-line treatment](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#further-line-treatment) - [chronic depressive symptoms](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#chronic-depressive-symptoms) - [depression in people with a diagnosis of personality disorder](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#depression-in-people-with-a-diagnosis-of-personality-disorder) - [psychotic depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#psychotic-depression) - [electroconvulsive therapy](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#electroconvulsive-therapy-for-depression), [transcranial magnetic stimulation](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#transcranial-magnetic-stimulation-for-depression) and [treatment-resistant depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#treatment-resistant-depression) - [access, coordination and delivery of care](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#access-coordination-and-delivery-of-care). ##### See visual summaries on the recommendations for: - [discussing first-line treatments for less severe depression](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006) - [discussing first-line treatments for more severe depression](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007) - [preventing relapse](https://www.nice.org.uk/guidance/ng222/resources/preventing-relapse-pdf-11131007008) - [further-line treatment](https://www.nice.org.uk/guidance/ng222/resources/furtherline-treatment-pdf-11131007009) - [treatment options for chronic depression, depression with personality disorder or psychotic depression](https://www.nice.org.uk/guidance/ng222/resources/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010) - [the matched care model](https://www.nice.org.uk/guidance/ng222/resources/the-matched-care-model-pdf-11131007011) [![View visual summary 1](https://www.nice.org.uk/Media/Default/guidance/NG222-1.PNG)](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006) [![View visual summary 2](https://www.nice.org.uk/Media/Default/guidance/NG222-2.PNG)](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007)[![View visual summary 3](https://www.nice.org.uk/Media/Default/guidance/NG222-3.PNG)](https://www.nice.org.uk/guidance/ng222/resources/preventing-relapse-pdf-11131007008) [![View visual summary 4](https://www.nice.org.uk/Media/Default/guidance/NG222-4.PNG)](https://www.nice.org.uk/guidance/ng222/resources/furtherline-treatment-pdf-11131007009)[![View visual summary 5](https://www.nice.org.uk/Media/Default/guidance/NG222-5.PNG)](https://www.nice.org.uk/guidance/ng222/resources/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010)[![View visual summary 6](https://www.nice.org.uk/Media/Default/guidance/NG222-6.PNG)](https://www.nice.org.uk/guidance/ng222/resources/the-matched-care-model-pdf-11131007011) ### Who is it for? - Healthcare professionals - Other professionals who have direct contact with, or provide health and other public services for, people with depression - Commissioners and providers of services for people with depression - People with depression, their families and carers ### Guideline development process [How we develop NICE guidelines](https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/how-we-develop-nice-guidelines) This guideline was previously called depression in adults: recognition and management. #### Your responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the [Yellow Card Scheme](https://www.gov.uk/report-problem-medicine-medical-device). Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should [assess and reduce the environmental impact of implementing NICE recommendations](https://www.nice.org.uk/about/who-we-are/sustainability) wherever possible. ### Related quality standards [Depression in adults](https://www.nice.org.uk/guidance/qs8) * [Next page Recommendations](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations) [Back to top](https://www.nice.org.uk/guidance/ng222#top) - [Guidance](https://www.nice.org.uk/guidance) - [Standards and indicators](https://www.nice.org.uk/standards-and-indicators) - [Clinical Knowledge Summaries (CKS) Clinical Knowledge SummariesClinical Knowledge Summaries](https://cks.nice.org.uk/) - [British National Formulary (BNF) British National FormularyBritish National Formulary](https://bnf.nice.org.uk/) - [BNF for Children (BNFC) British National Formulary for ChildrenBritish National Formulary for Children](https://bnfc.nice.org.uk/) - [Life sciences](https://www.nice.org.uk/about/what-we-do/life-sciences) - [Library and knowledge services](https://www.nice.org.uk/library-and-knowledge-services) - [What NICE does](https://www.nice.org.uk/what-nice-does) - [Implementing NICE guidance](https://www.nice.org.uk/implementing-nice-guidance) - [Get involved](https://www.nice.org.uk/get-involved) - [About us](https://www.nice.org.uk/about-us) - [Careers](https://www.nice.org.uk/careers) - [News, blogs and podcasts](https://www.nice.org.uk/news) - [Newsletters and alerts](https://www.nice.org.uk/nice-newsletters-and-alerts) - [Contact us](https://www.nice.org.uk/contact-us) - [Leave feedback](https://www.nice.org.uk/forms/leave-feedback) - [Reusing our content](https://www.nice.org.uk/reusing-our-content) - [NICE UK Open Content Licence](https://www.nice.org.uk/forms/use-of-nice-content-in-the-uk) - [Syndicate our content](https://www.nice.org.uk/about/what-we-do/nice-syndication-api) - [Events](https://www.nice.org.uk/events) - [Facebook](https://en-gb.facebook.com/NationalInstituteforHealthandCareExcellence/) - [X](https://x.com/NICEcomms) - [YouTube](https://www.youtube.com/user/NICEmedia) - [LinkedIn](https://www.linkedin.com/company/national-institute-for-health-and-clinical-excellence) - [Accessibility](https://www.nice.org.uk/accessibility) - [Freedom of information](https://www.nice.org.uk/freedom-of-information) - [Glossary](https://www.nice.org.uk/glossary) - [Terms and conditions](https://www.nice.org.uk/terms-and-conditions) - [Privacy notice](https://www.nice.org.uk/privacy-notice) - [Cookies](https://www.nice.org.uk/cookies) © NICE 2026. All rights reserved. Subject to [Notice of rights](https://www.nice.org.uk/terms-and-conditions#notice-of-rights).
Readable Markdown	This guideline covers identifying, treating and managing depression in people aged 18 and over. It recommends treatments for first episodes of depression and further-line treatments, and provides advice on preventing relapse, and managing chronic depression, psychotic depression and depression with a coexisting diagnosis of personality disorder. NICE has also produced a [guideline on depression in adults with a chronic physical health problem](http://www.nice.org.uk/guidance/CG91). Last reviewed: 30 January 2026 We reviewed this guideline and will not update the recommendations. See the [surveillance decision](https://www.nice.org.uk/guidance/ng222/resources/january-2026-exceptional-surveillance-of-depression-in-adults-treatment-and-management-nice-15604053806/chapter/surveillance-proposal?tab=evidence) for further details. This guideline updates and replaces NICE guideline CG90 (October 2009). Next review: This guideline will be reviewed if there is new evidence that is likely to change the recommendations. How we prioritise updating our guidance Decisions about updating our guidance are made by NICE’s prioritisation board. For more information on the principles and process see [NICE-wide topic prioritisation: the manual](https://www.nice.org.uk/process/pmg46 "https://www.nice.org.uk/process/pmg46"). For information about individual topics, including any decisions affecting this guideline, see the [summary table of prioritisation board decisions](https://www.nice.org.uk/about/what-we-do/prioritising-our-guidance-topics/our-prioritisation-decisions "https://www.nice.org.uk/about/what-we-do/prioritising-our-guidance-topics/our-prioritisation-decisions"). ### Recommendations This guideline includes recommendations on: - [principles of care](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#principles-of-care) - [recognition and assessment](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#recognition-and-assessment) - [choice](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#choice-of-treatments) and [delivery of treatments](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#delivery-of-treatments) - [treatment for a new episode of less severe depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#treatment-for-a-new-episode-of-less-severe-depression) - [treatment for a new episode of more severe depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#treatment-for-a-new-episode-of-more-severe-depression) - [behavioural couples therapy](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#behavioural-couples-therapy-for-depression) - [preventing relapse](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#preventing-relapse) - [further-line treatment](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#further-line-treatment) - [chronic depressive symptoms](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#chronic-depressive-symptoms) - [depression in people with a diagnosis of personality disorder](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#depression-in-people-with-a-diagnosis-of-personality-disorder) - [psychotic depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#psychotic-depression) - [electroconvulsive therapy](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#electroconvulsive-therapy-for-depression), [transcranial magnetic stimulation](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#transcranial-magnetic-stimulation-for-depression) and [treatment-resistant depression](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#treatment-resistant-depression) - [access, coordination and delivery of care](https://www.nice.org.uk/guidance/ng222/chapter/Recommendations#access-coordination-and-delivery-of-care). ##### See visual summaries on the recommendations for: - [discussing first-line treatments for less severe depression](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006) - [discussing first-line treatments for more severe depression](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007) - [preventing relapse](https://www.nice.org.uk/guidance/ng222/resources/preventing-relapse-pdf-11131007008) - [further-line treatment](https://www.nice.org.uk/guidance/ng222/resources/furtherline-treatment-pdf-11131007009) - [treatment options for chronic depression, depression with personality disorder or psychotic depression](https://www.nice.org.uk/guidance/ng222/resources/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010) - [the matched care model](https://www.nice.org.uk/guidance/ng222/resources/the-matched-care-model-pdf-11131007011) [![View visual summary 1](https://www.nice.org.uk/Media/Default/guidance/NG222-1.PNG)](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-less-severe-depression-pdf-11131007006) [![View visual summary 2](https://www.nice.org.uk/Media/Default/guidance/NG222-2.PNG)](https://www.nice.org.uk/guidance/ng222/resources/discussing-firstline-treatments-for-more-severe-depression-pdf-11131007007)[![View visual summary 3](https://www.nice.org.uk/Media/Default/guidance/NG222-3.PNG)](https://www.nice.org.uk/guidance/ng222/resources/preventing-relapse-pdf-11131007008) [![View visual summary 4](https://www.nice.org.uk/Media/Default/guidance/NG222-4.PNG)](https://www.nice.org.uk/guidance/ng222/resources/furtherline-treatment-pdf-11131007009)[![View visual summary 5](https://www.nice.org.uk/Media/Default/guidance/NG222-5.PNG)](https://www.nice.org.uk/guidance/ng222/resources/treatment-options-for-chronic-depression-depression-with-personality-disorder-or-psychotic-depression-pdf-11131007010)[![View visual summary 6](https://www.nice.org.uk/Media/Default/guidance/NG222-6.PNG)](https://www.nice.org.uk/guidance/ng222/resources/the-matched-care-model-pdf-11131007011) ### Who is it for? - Healthcare professionals - Other professionals who have direct contact with, or provide health and other public services for, people with depression - Commissioners and providers of services for people with depression - People with depression, their families and carers ### Guideline development process [How we develop NICE guidelines](https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/how-we-develop-nice-guidelines) This guideline was previously called depression in adults: recognition and management. #### Your responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the [Yellow Card Scheme](https://www.gov.uk/report-problem-medicine-medical-device). Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should [assess and reduce the environmental impact of implementing NICE recommendations](https://www.nice.org.uk/about/who-we-are/sustainability) wherever possible.
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