title: [How to define treatment-resistant depression?].
abstract: The most largely used definition of the treatment-resistant depression relies on the failure of two successive trials of antidepressant treatment at an adequate dose and duration. The absence of response to previous antidepressant treatments should be assessed using specific and appropriate clinical instruments enabling a correct staging of the therapeutic resistance. A wide range of socio-demographic and clinical factors (i.e. psychiatric/somatic comorbidities) are classically associated with the therapeutic resistance. The aim of the treatment of major depression is to achieve a complete clinical remission. The presence of residual symptoms increases the risk for the subsequent occurrence of relapses and recurrences, hence facilitating the development of therapeutic resistance. The treatment-resistant depression has a deleterious impact on the social, familial or professional functioning, thereby leading to an impaired quality of life with serious socioeconomic consequences and costs.
authors.affiliation: CHU de Grenoble, hôpital Nord, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, CS 10217, 38043 Grenoble cedex 9, France. Electronic address: jholtzmann@chu-grenoble.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Holtzmann
authors.affiliation: CHU La-Conception, pôle psychiatrie centre, centre expert dépression résistante fondamental, 13005 Marseille, France.
authors.forename: Raphaëlle
authors.initials: R
authors.lastname: Richieri
authors.affiliation: Hôpital Chenevier, Henri-Mondor, pôle de psychiatrie des hôpitaux universitaires, centre expert dépression résistante fondamental, 94000 Créteil, France.
authors.forename: Ghassen
authors.initials: G
authors.lastname: Saba
authors.affiliation: Hôpital Fernand-Widal, centre expert dépression résistante fondamental, service de psychiatrie adulte, 75010 Paris, France.
authors.forename: Najib
authors.initials: N
authors.lastname: Allaïli
authors.affiliation: Centre hospitalier Le-Vinatier, centre expert dépression résistante fondamental, service universitaire de psychiatrie adulte, BP 300 39, 69678 Bron cedex, France.
authors.forename: Rémy
authors.initials: R
authors.lastname: Bation
authors.affiliation: CHRU Lapeyronie, centre expert dépression résistante fondamental, département des urgences et post-urgences psychiatrique, 34295 Montpellier cedex 5, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Moliere
authors.affiliation: Hôpital Fernand-Widal, centre expert dépression résistante fondamental, service de psychiatrie adulte, 75010 Paris, France.
authors.forename: Isabel
authors.initials: I
authors.lastname: Nieto
authors.affiliation: Hôpital Fernand-Widal, centre expert dépression résistante fondamental, service de psychiatrie adulte, 75010 Paris, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Bellivier
authors.affiliation: CHU de Besançon, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, 25030 Besançon cedex, France.
authors.forename: Djamila
authors.initials: D
authors.lastname: Bennabi
authors.affiliation: CHRU de Lille, hôpital Fontan 1, centre expert dépression résistante fondamental, service de psychiatrie adulte, 59037 Lille cedex, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Bubrovszky
authors.affiliation: CHU de Tours, clinique psychiatrique universitaire, centre expert dépression résistante fondamental, 37044 Tours cedex 9, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Camus
authors.affiliation: CHU de Clermont-Ferrand, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte B, 63003 Clermont-Ferrand, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Charpeaud
authors.affiliation: CHU de Grenoble, hôpital Nord, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, CS 10217, 38043 Grenoble cedex 9, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Courvoisier
authors.affiliation: Centre hospitalier Le-Vinatier, centre expert dépression résistante fondamental, service universitaire de psychiatrie adulte, BP 300 39, 69678 Bron cedex, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Haesebaert
authors.affiliation: CH Charles-Perrens, centre expert dépression résistante fondamental, pôle de psychiatrie générale et universitaire, 33076 Bordeaux cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Doumy
authors.affiliation: CHRU Lapeyronie, centre expert dépression résistante fondamental, département des urgences et post-urgences psychiatrique, 34295 Montpellier cedex 5, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.affiliation: CHU de Tours, clinique psychiatrique universitaire, centre expert dépression résistante fondamental, 37044 Tours cedex 9, France.
authors.forename: Wissam
authors.initials: W
authors.lastname: El-Hage
authors.affiliation: CHU de Clermont-Ferrand, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte B, 63003 Clermont-Ferrand, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Garnier
authors.affiliation: Centre hospitalier Le-Vinatier, centre expert dépression résistante fondamental, service universitaire de psychiatrie adulte, BP 300 39, 69678 Bron cedex, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: d'Amato
authors.affiliation: CHU La-Conception, pôle psychiatrie centre, centre expert dépression résistante fondamental, 13005 Marseille, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lançon
authors.affiliation: Hôpital Chenevier, Henri-Mondor, pôle de psychiatrie des hôpitaux universitaires, centre expert dépression résistante fondamental, 94000 Créteil, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: CHU de Clermont-Ferrand, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte B, 63003 Clermont-Ferrand, France.
authors.forename: Pierre-Michel
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: CHRU de Lille, hôpital Fontan 1, centre expert dépression résistante fondamental, service de psychiatrie adulte, 59037 Lille cedex, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Vaiva
authors.affiliation: CHU de Grenoble, hôpital Nord, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, CS 10217, 38043 Grenoble cedex 9, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Bougerol
authors.affiliation: CH Charles-Perrens, centre expert dépression résistante fondamental, pôle de psychiatrie générale et universitaire, 33076 Bordeaux cedex, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Aouizerate
authors.affiliation: CHU de Besançon, centre expert dépression résistante fondamental, service de psychiatrie de l'adulte, 25030 Besançon cedex, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Haffen
mesh_terms: D000928:Antidepressive Agents / Q000145:classification / Q000493:pharmacokinetics / Q000627:therapeutic use; D001361:Avitaminosis / Q000175:diagnosis; D059350:Chronic Pain / Q000175:diagnosis; D015897:Comorbidity; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D004347:Drug Interactions; D004351:Drug Resistance; D057915:Drug Substitution; D004565:Electroconvulsive Therapy; D004700:Endocrine System Diseases / Q000175:diagnosis; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis; D010349:Patient Compliance; D011594:Psychometrics; D011788:Quality of Life; D012008:Recurrence; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology
chemical_list: D000928:Antidepressive Agents