title: Treatment resistant depression in an Australian context. I: The utility of the term and approaches to management.
abstract: The concept of "treatment resistant depression" (TRD) has generally been defined in terms of failure to respond to a standard course of somatic therapy with little reference to diagnostic sub-types or relevant psychosocial factors. In this paper we examine problems with the use of the term "treatment resistant depression" and then outline an approach to TRD employed in an Australian mood disorders unit. After discussing the need for a biopsychosocial assessment, multimodal management strategies for melancholic and non-melancholic TRD patients are described.
authors.affiliation: Mood Disorders Unit, Prince Henry Hospital, Little Bay, New South Wales.
authors.forename: K
authors.initials: K
authors.lastname: Wilhelm
authors.forename: P
authors.initials: P
authors.lastname: Mitchell
authors.forename: P
authors.initials: P
authors.lastname: Boyce
authors.forename: I
authors.initials: I
authors.lastname: Hickie
authors.forename: H
authors.initials: H
authors.lastname: Brodaty
authors.forename: M P
authors.initials: MP
authors.lastname: Austin
authors.forename: G
authors.initials: G
authors.lastname: Parker
mesh_terms: D000341:Affective Disorders, Psychotic / Q000628:therapy; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001315:Australia; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000145:classification / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D006801:Humans; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D009483:Neuropsychological Tests; D011613:Psychotherapy; D012008:Recurrence; D012649:Self Concept; D012720:Severity of Illness Index; D012917:Social Adjustment; D009626:Terminology as Topic; D016896:Treatment Outcome
chemical_list: D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D008996:Monoamine Oxidase Inhibitors