Approach to Diagnosis and Management of Treatment-Resistant Depression

Psychiatr Clin North Am. 2023 Jun;46(2):247-259. doi: 10.1016/j.psc.2023.02.011. Epub 2023 Mar 27.

Abstract

Major depressive disorder is a chronic and recurrent illness that affects 20% of adults during their lifetime and is one of the leading causes of suicide in the United States. A systematic measurement-based care approach is the essential first step in the diagnosis and management of treatment-resistant depression (TRD) by promptly identifying individuals with depression and avoiding delays in treatment initiation. As comorbidities may be associated with poorer outcomes to commonly used antidepressants and increase risk of drug-drug interactions, their recognition and treatment is an essential component of management of TRD.

Keywords: Diagnosis and treatment; Management approaches; Structured assessment; Treatment-resistant depression.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Comorbidity
  • Depression
  • Depressive Disorder, Major* / diagnosis
  • Depressive Disorder, Major* / drug therapy
  • Depressive Disorder, Treatment-Resistant* / diagnosis
  • Depressive Disorder, Treatment-Resistant* / drug therapy
  • Humans
  • United States

Substances

  • Antidepressive Agents