A Review of the Conceptualisation and Risk Factors Associated with Treatment-Resistant Depression
Open Access
- 3 August 2017
- journal article
- review article
- Published by Hindawi Limited in Depression Research and Treatment
- Vol. 2017, 1-10
- https://doi.org/10.1155/2017/4176825
Abstract
Major depression does not always remit. Difficult-to-treat depression is thought to contribute to the large disease burden posed by depression. Treatment-resistant depression (TRD) is the conventional term for nonresponse to treatment in individuals with major depression. Indicators of the phenomenon are the poor response rates to antidepressants in clinical practice and the overestimation of the efficacy of antidepressants in medical scientific literature. Current TRD staging models are based on anecdotal evidence without an empirical rationale to rank one treatment strategy above another. Many factors have been associated with TRD such as inflammatory system activation, abnormal neural activity, neurotransmitter dysfunction, melancholic clinical features, bipolarity, and a higher traumatic load. This narrative review provides an overview of this complex clinical problem and discusses the reconceptualization of depression using an illness staging model in line with other medical fields such as oncology.Keywords
This publication has 79 references indexed in Scilit:
- The role of BDNF, NTRK2 gene and their interaction in development of treatment-resistant depression: Data from multicenter, prospective, longitudinal clinic practiceJournal of Psychiatric Research, 2013
- A Systematic Review of Comparative Efficacy of Treatments and Controls for DepressionPLOS ONE, 2012
- Classification of Different Therapeutic Responses of Major Depressive Disorder with Multivariate Pattern Analysis Method Based on Structural MR ScansPLOS ONE, 2012
- Immune suppression and immune activation in depressionBrain, Behavior, and Immunity, 2011
- What Did STAR*D Teach Us? Results From a Large-Scale, Practical, Clinical Trial for Patients With DepressionPsychiatric Services, 2009
- Interaction Between the Serotonin Transporter Gene (5-HTTLPR), Stressful Life Events, and Risk of DepressionJAMA, 2009
- Amino Acid Neurotransmitters Assessed by Proton Magnetic Resonance Spectroscopy: Relationship to Treatment Resistance in Major Depressive DisorderBiological Psychiatry, 2009
- Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depressionBrain Structure and Function, 2008
- Selective Publication of Antidepressant Trials and Its Influence on Apparent EfficacyThe New England Journal of Medicine, 2008
- Targeting abnormal neural circuits in mood and anxiety disorders: from the laboratory to the clinicNature Neuroscience, 2007