Alfred Perera's blog

NICE Guidelines there 2005, 2013, 2015

In the UK the National Institute for Health and Care Excellence (NICE) had published guidelines in 2005 for the treatment of depression in young people. These guidelines were updated in 2013 and 2015. After an assessment, if a young person is diagnosed with depression they should be offered therapy. This would usually consist of Cognitive Behaviour Therapy (CBT), Family Therapy or Interpersonal Therapy (IPT). In practise, there is usually a delay of several months for most young people before they can access therapy.

Brain Derived Neurotropic Factor

The brain is even more than a veritable soup of chemicals mixed with a spaghetti junction of endless combinations of nerve connections. How do our nerves remain healthy? They need Brain Derived Neurotropic Factor (BDNF) to grow and maintain their function. However, in stressful situations there is a reduction in BDNF in key brain areas, especially the hippocampus.

The hippocampus of the rat has been studied by John O'Keefe who won the Nobel Prize for Medicine last year. We now know that this region of the brain possesses its own stem cells which can be made into new nerve cells.

The UK Government

In the UK, we are lucky that our government gives £717,000,000 a year for the funding of child and adolescent mental health services. However this is £50,000,000 less than in 2010 under the previous government. Even after seven years as a NHS Consultant, I cannot get severely depressed teenagers into therapeutic work promptly because we just do not have enough professionals working in CAMHS.

Our government will need to ensure that we can do more for young people's health, education, employment and life prospects to contribute to this Great Britain.

Depression in Teenage Pregnancy

In the UK, the National Institute of Clinical Excellence (NICE) produced Guideline CR192 to focus on the clinical management of antenatal and postnatal mental health.

The focus of this document is the wide range of mental illnesses such as depression, psychosis, anxiety, eating disorders, drug and alcohol use disorders.

2.9 in 100 girls in the UK between the ages of 15 and 19 years give birth which is high compared to other countries 0,9 per 100 in France, 1.1 per 100 in Germany and 0.4 per 100 in Japan. In the UK there are 48000 babies born each year to teenage mothers.

Depression Care Pathway

Happy New Year for 2015!

3% of all young people from the teenage years to young adulthood experience severe depression but only a quarter of individuals receive any kind of treatment. In my NHS practice in the UK I have been able to assess young people promptly when they have been referred in by their GP but there has been too much of a delay in enabling them to access cognitive behaviour therapy with one of our therapists.