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[How to define treatment-resistant depression?].

Jérôme Holtzmann1, Raphaëlle Richieri2, Ghassen Saba3

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Treatment-resistant depression (TRD) is defined by failing two antidepressant trials. Accurate assessment and managing comorbidities are crucial for effective TRD management and improving patient outcomes.

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Area of Science:

  • Psychiatry
  • Clinical Psychology

Context:

  • Treatment-resistant depression (TRD) is a significant clinical challenge.
  • The standard definition involves failure of two adequate antidepressant trials.
  • Accurate staging of therapeutic resistance is essential.

Purpose:

  • To define treatment-resistant depression (TRD).
  • To highlight factors associated with TRD, including comorbidities.
  • To emphasize the importance of achieving complete remission in major depression treatment.

Summary:

  • TRD is characterized by a lack of response to at least two antidepressant treatments.
  • Socio-demographic and clinical factors, such as comorbidities, are linked to TRD.
  • Residual symptoms after treatment increase relapse risk and contribute to TRD.

Impact:

  • TRD significantly impairs social, familial, and professional functioning.
  • It leads to a reduced quality of life.
  • TRD results in substantial socioeconomic costs.