Definitions for treatment-resistant depression vary. In the current study, researchers defined the condition as ‘failure to respond to at least two sequential trials of antidepressants’. Those who have treatment-resistant depression have higher risks of other psychiatric conditions, including anxiety, self-harm, personality disorders, and physical health conditions like heart disease.
In the present study, researchers examined clinical and service-level associations of treatment-resistant depression alongside the experiences of people with the condition and clinicians involved in their care within a large and diverse National Health trust in the UK. To do so, they analyzed electronic health records and conducted thematic analysis of semi-structured interviews.
Ultimately, they found that 48% of patients with major depressive disorder met the criteria for treatment-resistant depression, with 36.9% of patients having tried four or more treatments. They further found that those with treatment-resistant depression had higher rates of recurrent depression, comorbid anxiety disorders, personality disorders, self-harm, and cardiovascular diseases. More treatment resistance correlated with more economic inactivity and greater functional loss.
"There is an irony that the experience of struggling to treat depression is in itself a risk factor for a worsening sense of 'hopelessness' as one patient described it. This should be a clarion call to recognise that treatment-resistant depression needs to be factored into clinical decision making and the ongoing support that patients are offered," said corresponding study author, Kiranpreet Gill, PhD researcher at the School of Psychology at the University of Birmingham, in a press release.
"This study is important as the data demonstrates people with TRD are at a higher risk of a range of poorer outcomes, and that we need better defined care pathways for helping this population, and are in urgent need of developing and testing new treatments for this group,” said co-author of the study, Professor Steven Marwaha, Clinical Professorial Fellow at the Institute for Mental Health at the University of Birmingham in a press release.
Sources: Science Daily, British Journal of Psychiatry
