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Related Experiment Videos

Treatment resistant depression: a clinical perspective.

G W MacEwan1, R A Remick

  • 1Department of Psychiatry, University of British Columbia, Vancouver.

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|December 1, 1988
PubMed
Summary

Specialized mood disorder clinics effectively treat treatment-resistant depression (TRD). Individualized care led to significant symptom remission in over 60% of patients, highlighting the value of expert services.

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Area of Science:

  • Psychiatry
  • Clinical Psychology

Background:

  • Treatment-resistant depression (TRD) poses a significant clinical challenge.
  • Accurate diagnosis is crucial for effective management of mood disorders.

Purpose of the Study:

  • To evaluate the effectiveness of specialized care in a Mood Disorders Clinic for patients diagnosed with TRD.
  • To identify diagnostic profiles and patient characteristics associated with varying treatment outcomes.

Main Methods:

  • One hundred fourteen patients with TRD were assessed and treated.
  • Diagnostic criteria were applied to classify patients into bipolar disorder, recurrent depression, or other affective disorders.
  • Hamilton Depression Rating Scale (Ham-D) was used for symptom assessment.

Main Results:

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  • 52% of patients had bipolar disorder, 43% recurrent depression, and 11% other conditions.
  • 60.2% of treated patients achieved complete symptom remission (final Ham-D 5.9).
  • Partial remission was observed in 18 patients (final Ham-D 15.9), and 8 patients showed absolute TRD (final Ham-D 23.4).
  • Partial and absolute TRD were associated with older age, more Axis II diagnoses, and substance abuse history.

Conclusions:

  • Specialized mood disorder services are valuable for managing TRD.
  • Individualized treatment approaches can lead to substantial symptom improvement.
  • Understanding patient comorbidities and history is important for optimizing TRD management.