NICE NG222 Depression

Depression in adults: treatment and management (NICE guideline NG222)

NG222 replaced the 2009 depression guideline and reorganised treatment around a menu of equally weighted first-line options — psychological therapy, medication, or both — chosen with the patient rather than dictated by a stepped-care ladder, with severity split into 'less severe' and 'more severe' rather than graded by symptom count. It sets out sequencing for inadequate response, combination and augmentation in treatment-resistant depression, and relapse prevention including mindfulness-based cognitive therapy. The register trials the guideline rests on are grouped below by treatment modality.

This guideline cites 8 of the 62 landmark trials in our Psychiatry & psychotherapy register.

Source
National Institute for Health and Care Excellence. Depression in adults: treatment and management. NICE guideline [NG222]. Published 29 June 2022; last reviewed 30 January 2026.

Psychological therapy: CBT & behavioural activation3

  • 2006Dimidjian BAPsychiatry · Depression · Behavioural activationBehavioural Activation vs Cognitive Therapy vs Antidepressant
  • 2005DeRubeis-HollonPsychiatry · Depression · CBT vs pharmaCognitive Therapy vs Medications in Moderate-to-Severe Depression
  • 1989NIMH TDCRPPsychiatry · Depression · CBT vs pharmaNIMH Treatment of Depression Collaborative Research Program

Pharmacotherapy & sequenced next-step treatment1

  • 2006STAR*DPsychiatry · Depression · Sequential strategiesSequenced Treatment Alternatives to Relieve Depression

Combination & augmentation in treatment-resistant depression1

  • 2013CoBalTPsychiatry · Depression · Treatment-resistantCBT as Adjunct in Treatment-Resistant Depression

Relapse prevention: mindfulness-based cognitive therapy3

  • 2015PREVENTPsychiatry · Depression · Relapse preventionMBCT-Taper vs Maintenance Antidepressant
  • 2004Ma & TeasdalePsychiatry · Depression · Relapse preventionReplication of MBCT for Depression Relapse
  • 2000Teasdale MBCTPsychiatry · Depression · Relapse preventionMindfulness-Based Cognitive Therapy for Relapse Prevention

Published since the guideline1

  • 2023Cuijpers 2023Psychiatry · Depression · Meta-analysisMega-Meta-Analysis of CBT for Adult Depression