Exercise First-Line Depression — MRCPsych Paper B MCQ
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Correct answer: B — It can be offered as one of several first-line treatment options
NICE includes structured group exercise among the first-line treatment options for a new episode of less severe depression. Treatment should be selected through shared decision-making, although guided self-help is generally considered first because it is less intrusive and resource intensive. The exercise intervention is not simply advice to exercise: it is delivered by a trained practitioner, specifically designed for people with depression, and usually includes moderate-intensity aerobic exercise more than once weekly for 10 weeks. It does not need to follow unsuccessful antidepressant treatment, and antidepressants are not routinely offered first line for less severe depression unless they are the person's informed preference. Group exercise is an option rather than being preferred to every psychological intervention.
Reference: National Institute for Health and Care Excellence. Depression in adults: treatment and management (NG222), recommendations 1.5.2–1.5.3 and Table 1. 2022; reviewed 2026. https://www.nice.org.uk/guidance/ng222/chapter/Recommendations