Tailoring treatment for Major Depressive Episode: Lessons learned from the inpatient unit

Major depressive disorder (MDD) represents one of the main diagnosis of admission to the inpatient psychiatric unit, because of the frequent comorbid suicidal behavior. It is a clinically heterogeneous diagnostic category comprising a various array of symptoms presentation. This clinical heterogeneity can represent a challenge for treatment, and patients are often discharged with substantial residual symptomatology that still impacts functioning1. Characterizing subtypes of major depressive disorder ad admission could possibly help tailoring treatment and improving outcomes. The aim of the study was to detected clinical signs at admission for tailoring treatment (that includes pharmacotherapy, cognitive behavioral therapy, individual psychoeducation) in order to prevent suicide, improve quality of life and reduce re-hospitalization. Tailored treatment was routinely implemented in a sample of patient with a major depressive episode consecutively admitted to an inpatient psychiatric unit from 1^st april 2018 to 31^st august 2018. Results showed that, at 5 months follow up, it was associated to symptoms reduction, improved quality of life and reduction of hospitalization. The limited sample size, the absence of a control group and the naturalistic structure of the study, limit the generalizability of those results. However, those preliminary findings could provide a blueprint for a larger study and a longer follow up.