Nice | Depression in children and young people

This is an updated guideline from Nice on managing depression in children. Most of the advice is the same and the changes really just follow normal practice. I've highlighted the changes below.

Assessment (no change here)

Consider using the Mood and Feelings Questionnaire. A score of 12 or more supports a diagnosis of depression.

Mild depression

Watchful waiting (review after 2w and continue for up to 4w). If this doesn't help THEN

  • Non directed supportive therapy (I presume this means counselling) OR
  • Group CBT OR
  • Supported self-help

If there is no improvement after 2 - 3m, then refer to CAMHS.

Moderate to severe depression

  • Refer to CAMHS
  • Psychological therapy (eg CBT) for 3m if helping. If there is no improvement after 4 - 6 sessions THEN
  • Combination therapy with an antidepressant. Combination therapy can be considered first line.

Antidepressant use

  • Fluoxetine 10mg is first line as the others do not have the same evidence of benefit.
  • It should only be started after psychiatrist review
  • Patients should be reviewed weekly for 4w (including for thoughts of self harm).


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