Depression treatment: a lifelong commitment?
Depression is associated with considerable disability, morbidity, and mortality. In many patients, depression follows a course of relapse and/or recurrence. However, there is significant evidence that the majority of patients with depressive disorders are undertreated and this imposes a substantial economic burden on society. The reasons for undertreatment include patient, provider, and healthcare system factors. It is vital that treatment be targeted appropriately to break the cycle of relapse/recurrence. Rather than short-term improvement of symptoms, the optimal outcome of treatment of depressive disorders should be full symptom resolution (remission) and long-term recovery. Patients with histories of recurrent depressive episodes may require long-term, indefinite treatment with antidepressants. Currently, few data exist on the outcome and appropriate duration of maintenance pharmacotherapy. The benefits of psychotherapy have recently been demonstrated in a 12-week, randomized, controlled study, which also includes a maintenance phase that has not yet been completed. Additional well-designed studies addressing these issues are urgently needed.
Keller
Martin B
MB
Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02906, USA. sheri_harrison@brown.edu
Berndt
Ernst R
ER
D000928:Antidepressive Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D004565:Electroconvulsive Therapy; D006801:Humans; D011613:Psychotherapy / Q000379:methods; D012008:Recurrence; D016896:Treatment Outcome; D016312:Treatment Refusal
D000928:Antidepressive Agents