Mindfulness included in NICE recommended treatment for depression

NICE: the UK National Institue for Health and Care excellence publishes evidence based recommendations for doctors and paramedics to follow

NICE reports are thorough and specialised but largely understandable to the general public. If you visit NICE you can enter any condition in the search box and read the advice which doctors are advised to follow in treating any condition.

The recommendations are hammered out by groups of specialists of all backgrounds and are continually updated to take account of new research findings. The full guidelines are quite overwhelming in scale, so I've provided an excerpt below.

It's interesting to note that mindfulness-based treatments are now included in the section dealing with preventing recurrence of episodes of depression and also for social anxiety disorder. Here is an excerpt from the October 2009 updated guidance about non-drug treatment of depression:

Psychological interventions for relapse prevention

1.9.1.8 People with depression who are considered to be at significant risk of relapse (including those who have relapsed despite antidepressant treatment or who are unable or choose not to continue antidepressant treatment) or who have residual symptoms, should be offered one of the following psychological interventions: 

• individual CBT 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.

The advice is specific about the duration and frequency of mindfulness-based cognitive therapy.

Delivering psychological interventions for relapse prevention

1.9.1.9 For all people with depression who are having individual CBT for relapse prevention, the duration of treatment should typically be in the range of 16 to 20 sessions over 3 to 4 months. If the duration of treatment needs to be extended to achieve remission it should:

• consist of two sessions per week for the first 2 to 3 weeks of treatment
• include additional follow-up sessions, typically consisting of four to six sessions over the following 6 months. 

1.9.1.10 Mindfulness-based cognitive therapy should normally be delivered in groups of 8 to 15 participants and consist of weekly 2-hour meetings over 8 weeks and four follow-up sessions in the 12 months after the end of treatment.

It's a small, welcome recognition that a range of approaches are needed to prevent people spiralling into depression if they can't tolerate tablets or if the tablets don't help.

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