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Depression in children and young people: identification and management in primary, community and secondary care (NICE guideline CG28)
  1. Andrew Lawton1,
  2. Omer S Moghraby2
  1. 1Psychiatry Core Trainee (CT3), Edinburgh, UK
  2. 2Lewisham CAMHS, South London & the Maudsley NHS Foundation Trust, London, UK
  1. Correspondence to Dr Andrew Lawton, Psychiatry Core Trainee (CT3), Royal Edinburgh Hospital, Morningside Place, Edinburgh, EH10 5HF; andrew.lawton{at}nhs.net

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Introduction and information about the current guideline

The National Institute for Health and Care Excellence (NICE) guideline CG28 ‘Depression in children and young people: Identification and management in primary, community and secondary care’ was recently updated and was published in March 2015.1

This covers depression as defined by the International Classification of Diseases (ICD-10) in children (5–11 years) and young people (12–18 years). It provides specific recommendations on assessment and treatment stratified by severity and includes risk profiling, the role of specialist Child and Adolescent Mental Health Services (CAMHS) and the use of psychological and pharmacological interventions. Table 1 outlines some important definitions.

View this table:
Table 1

Important definitions

Previous guidelines

The original NICE guideline CG28 was published in 2005. This revision includes updated recommendations for some interventions and for future research. See box 1 for a link to this guidance and further resources.

Box 1

Resources

  • http://www.nice.org.uk/guidance/cg28/resources/guidance-depression-in-children-and-young-people-identification-and-management-in-primary-community-and-secondary-care-pdf

  • Link to the National Institute for Health and Care Excellence (NICE) full guideline

  • http://www.nice.org.uk/guidance/cg28/ifp/chapter/definitions-of-psychological-treatments

  • Link to public information on guideline

  • Hopkins, et al 20153

  • Summary of the guidance by the Clinical Guidelines Update Committee

Key issues that the guideline addresses

Risk profiling

A child/young person exposed to a single recent undesirable life event should be assessed for symptoms and risk factors for depression with a risk profile documented in their records. The assessment should ALWAYS consider possible child maltreatment (abuse may coexist with depression), self-harm or any suicidal thoughts and, in young people, directly address alcohol and drug use.

Children and young people referred to CAMHS without a diagnosis of depression should be screened with a self-report questionnaire such as Mood and Feelings Questionnaire (MFQ). The MFQ can also be used as an adjunct to clinical judgement when monitoring response to treatment.

Referral guidance

Mild depression …

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