Treatment recommendations versus treatment realities: recognizing the rift and understanding the consequences.
Depression is a treatable disorder, although it often requires long-term therapy. To aid physicians in the effective long-term management of depression, treatment guidelines have been established by a number of organizations with minimum treatment duration recommendations. Unfortunately, numerous studies document a significant disparity between these recommendations and clinical practice realities. In particular, studies have shown that fewer than half of treated patients receive the recommended duration of 6 months of continuation therapy. Other clinical practice studies have reported that early discontinuation from therapy is associated with a substantial increase in the risk of relapse or recurrence. Long-term treatment of depression in clinical practice settings may benefit from a closer approximation to the conditions found in clinical trial settings.
Frank
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Department of Psychiatry, School of Medicine, University of Pittsburgh, Penn 15213, USA. franke@msx.upmc.edu
Judge
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R
D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000379:methods / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D017063:Outcome Assessment, Health Care; D010352:Patient Dropouts; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D055502:Secondary Prevention; D017211:Treatment Failure; D016896:Treatment Outcome
D000928:Antidepressive Agents