Exercise for Depression — MRCPsych Paper B MCQ

Correct answer: E — Discuss a group exercise intervention as one first-line option, selected according to his clinical needs and preferences

NICE includes group exercise among the first-line treatment options that may be discussed for a new episode of less severe depression, with treatment chosen collaboratively according to clinical needs and preferences. The intervention is delivered by a trained practitioner, uses a programme designed for depression, usually occurs more than once weekly for 10 weeks, and includes moderate-intensity aerobic exercise. Guided self-help should generally be considered first because it is less intrusive and resource intensive, so exercise is an option rather than the universally preferred treatment. General self-directed physical activity may enhance wellbeing but is distinct from the therapeutic group intervention. Exercise is not restricted to antidepressant non-response and does not have to be combined with medication. NICE defines less severe depression as subthreshold or mild depression; moderate depression falls within its more severe category.

Reference: National Institute for Health and Care Excellence. Depression in adults: treatment and management (NG222), recommendations 1.5.2 and table 1. Published 2022; updated 2025. https://www.nice.org.uk/guidance/ng222/chapter/Recommendations