title: Risk factors for treatment resistance in unipolar depression: a systematic review.
abstract: BACKGROUND
  Treatment resistant depression is a complex disorder and an important source of morbidity and mortality. Identification of risk factors of resistance may be useful to improve early recognition as well as treatment selection and prediction of outcome in patients with depression.
  
  
  METHODS
  The aim of this paper was to review the current status of knowledge regarding risk factors of treatment resistance in unipolar depression, in patients who failed to respond to at least two successive and adequate antidepressant treatments.
  
  
  RESULTS
  Systematic literature search yielded 8 publications exploring clinical and biological factors. Specific psychiatric comorbidities, psychosocial factors, clinical characteristics of the depressive episode and biological markers emerge as possible risk factor for treatment resistant depression.
  
  
  CONCLUSIONS
  Due to the lack of objective definition and diagnostic criteria for treatment resistant depression, and the paucity of reports on risk factors, our review only summarized a small number of studies.
  
  
  CONCLUSIONS
  Future investigations of risk factors should help to improve the understanding of the mechanisms underlying resistance in mood disorders and contribute to improve their therapeutic management.
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France. Electronic address: dbennabi@chu-besancon.fr.
authors.forename: D
authors.initials: D
authors.lastname: Bennabi
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: B
authors.initials: B
authors.lastname: Aouizerate
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: W
authors.initials: W
authors.lastname: El-Hage
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: O
authors.initials: O
authors.lastname: Doumy
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: F
authors.initials: F
authors.lastname: Moliere
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: P
authors.initials: P
authors.lastname: Courtet
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: I
authors.initials: I
authors.lastname: Nieto
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: F
authors.initials: F
authors.lastname: Bellivier
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: M
authors.initials: M
authors.lastname: Bubrovsky
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: G
authors.initials: G
authors.lastname: Vaiva
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: J
authors.initials: J
authors.lastname: Holztmann
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: T
authors.initials: T
authors.lastname: Bougerol
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: R
authors.initials: R
authors.lastname: Richieri
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: C
authors.initials: C
authors.lastname: Lancon
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: V
authors.initials: V
authors.lastname: Camus
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: G
authors.initials: G
authors.lastname: Saba
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: F
authors.initials: F
authors.lastname: Haesbaert
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: T
authors.initials: T
authors.lastname: d'Amato
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: T
authors.initials: T
authors.lastname: Charpeaud
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: P M
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: M
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: Network of centres for Treatment-Resistant Depression, FondaMental Foundation, Créteil 94000, France.
authors.forename: E
authors.initials: E
authors.lastname: Haffen
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D061218:Depressive Disorder, Treatment-Resistant / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D055118:Medication Adherence / Q000523:psychology; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D012307:Risk Factors; D016903:Drug Monitoring
chemical_list: D000928:Antidepressive Agents
keywords: Treatment resistance-depression-risk factors