[Risk factors and psychosocial disability of treatment-resistant depression]

Resistant and/or chronic depression has severe consequences on social and professional functioning. Clinical and health-economic studies allowed the identification of the main factors involved in these adverse outcomes. Some factors are illness-dependent or related to personal characteristics, while others are linked to a wide range of psychosocial stresses. Guidelines have been developed to improve the pharmacological treatment of resistant depression, but they are not easy to implement and therapeutic failures are frequent. The knowledge of the factors influencing the evolution of depressive syndromes gives an empirical basis to assess their consequences on work capacity. It should also guide public health policies.