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NICE - the UK National Institute for Health and Clinical Excellence - recently published guidance on "Depression in adults (update)" and on "Depression with a chronic physical health problem".  The "Depression in adults (update)"  replaces guidance originally published in 2004 and amended in 2007.  The 28 page Quick reference guide provides a helpful overview.  Interestingly NICE here use the DSM-IV diagnostic criteria for depression rather than the ICD-10 criteria (used in their earlier publications).  A four step approach is charted - each step is described both by who the intervention is for (e.g.

Here are two papers on mindfulness and four on sleep.  The Kuyken et al paper is important.  It compares mindfulness-based cognitive therapy (MBCT) with continuation antidepressants in the prevention of relapse in recurrent depression.  The results are great - "Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM (maintenance antidepressant) group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04).  MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains."  I have been cautious in my enthusiasm for MBCT (see previous post) but this is exactly the kind of research that we need to help clarify MBCT's potential further.  The second paper on mindfulness is lower key.  It is a mention of its potential in enhancing sexuality.  It makes sense - see last month's posts on the effects of meditation training on experiencing positive emotions - but the relevant research is still in its early stages. 

This is the 5^th in a series of blog posts about the 10^th September SIGN draft guideline day on "Non-pharmacological management of depression."  On the day, the

Here are some articles - mostly published in May - that I found particularly interesting: