Journal article

The identification, assessment and management of difficult-to-treat depression: An international consensus statement

RH McAllister-Williams, C Arango, P Blier, K Demyttenaere, P Falkai, P Gorwood, M Hopwood, A Javed, S Kasper, GS Malhi, JC Soares, E Vieta, AH Young, A Papadopoulos, AJ Rush

Journal of Affective Disorders | ELSEVIER | Published : 2020


BACKGROUND: Many depressed patients are not able to achieve or sustain symptom remission despite serial treatment trials - often termed "treatment resistant depression". A broader, perhaps more empathic concept of "difficult-to-treat depression" (DTD) was considered. METHODS: A consensus group discussed the definition, clinical recognition, assessment and management implications of the DTD heuristic. RESULTS: The group proposed that DTD be defined as "depression that continues to cause significant burden despite usual treatment efforts". All depression management should include a thorough initial assessment. When DTD is recognized, a regular reassessment that employs a multi-dimensional fram..

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University of Melbourne Researchers


Funding Acknowledgements

An initial draft of the consensus statement was prepared by Samantha Stanbury, PhD, a professional medical writer contracted to Vivari Ltd., funded by LivaNova, based on the minutes of the concensus group meeitng held on 1st April 2019. RHMW developed subsequent drafts. Lumbini Azim and Paul Hindmarch, from Newcastle University and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, and Samantha Stanbury assisted with the production of the tables and figures. All authors reviewed the consensus statement, provided input to its development, and approved the final consensus statement. The authors thank Kate Clare and Rachel Kelly of Vivari Ltd. for organizing the consensus meeting and co-ordinating pre-meeting preparations and post-meeting development of the consensus statement.