Treating stubborn depression
At least one in three patients with depression won't respond well to a series of treatments and experts in the field have joined together to outline practical treatments to tackle the issue, in the Medical Journal of Australia Open.
Depression can be a stubborn problem—at least one in three patients fail to respond to proven therapies—and experts in the field have put their heads together to outline practical treatment approaches for general practitioners in an MJA Open supplement on "difficult-to-treat depression". "While GPs have many skills in the assessment and treatment of depression, they are often faced with people with depression who simply do not get better, despite the use of proven therapies, be they psychological or pharmacological", wrote Professor David Castle, Chair of Psychiatry at St Vincent's Health and the University of Melbourne, and coauthors.
They wrote that they hoped the approaches outlined in the supplement could assist clinicians—and GPs in particular—to improve the outcomes of patients with difficult-to-treat depression. In an article on pharmacological approaches to the problem, Dr Herng-Nieng Chan and Professor Philip Mitchell, psychiatrists with the University of New South Wales and the Black Dog Institute, and coauthors outlined the latest evidence-based drug treatment strategies for people with difficult-to-treat depression, based on studies including a US trial of almost 3000 patients.
The US study found that 30% of patients failed to achieve remission of their depression after using up to four different antidepressants. "This finding reflects the reality of clinical practice and highlights the need to employ the best available evidence in the management of people with complex depression", they wrote.
Professor Paul Fitzgerald, a psychiatrist from Monash Alfred Psychiatry Research Centre, wrote that electroconvulsive therapy remained the most widely used and effective biological non-drug treatment for difficult-to-treat depression.
However, he also detailed innovative new forms of brain stimulation, including magnetic seizure therapy and vagus nerve stimulation, which showed promise. "Ongoing work is required to define which treatments are likely to be most useful, and in which patient groups", he wrote.
Dr Melissa Casey, director of psychology at Southern Health, and coauthors wrote that evidencebased psychological approaches including cognitive behaviour therapy, interpersonal psychotherapy and family-based therapy could improve outcomes in difficult-to-treat depression.
As thought patterns and behaviour played a large role in determining outcomes of treatment for people with depression, they wrote, they were "prime candidates for intervention through a psychosocial treatment regimen".
Provided by University of New South Wales
- Nursing professor leads the way for 'telepsychiatry' by nurses to treat postpartum depression May 08, 2008 | not rated yet | 0
- Speech a new marker for depression treatment response Aug 13, 2012 | not rated yet | 0
- Looking at links between depression and insomnia Feb 27, 2012 | not rated yet | 0
- Brief psychological therapy is effective in primary care Jun 24, 2010 | not rated yet | 0
- Online treatment dramatically cuts suicide risk Sep 18, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
4 hours ago Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
(Medical Xpress)—The first symptoms of major depression may be behavioral, but the common mental illness is based in biology—and not limited to the brain.
Psychology & Psychiatry 39 minutes ago | not rated yet | 0 |
A new study shows there is a gender gap when it comes to behavior and self-control in American young children – one that does not appear to exist in children in Asia.
Psychology & Psychiatry 15 hours ago | not rated yet | 0
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
Psychology & Psychiatry 16 hours ago | 5 / 5 (2) | 3 |
What effect does a father's depression have on his young son or daughter? When fathers report a high level of emotional intimacy in their marriage, their children benefit, said a University of Illinois study.
Psychology & Psychiatry 16 hours ago | not rated yet | 0
(Medical Xpress)—Preschoolers universally recognize that one's choices are not always free – that our decisions may be constrained by social obligations to be nice to others or follow rules set by parents ...
Psychology & Psychiatry May 22, 2013 | not rated yet | 0
(Medical Xpress)—Researchers at the University of Virginia School of Medicine have identified a promising target for treating glioblastoma, one that appears to avoid many of the obstacles that typically frustrate efforts ...
45 minutes ago | not rated yet | 0 |
(Medical Xpress)—Scientists at Emory Vaccine Center have shown that an immune regulatory molecule called IL-21 is needed for long-lasting antibody responses in mice against viral infections.
33 minutes ago | not rated yet | 0 |
Human breastmilk responds quickly to protect the child when there is an infection in mothers or babies, according to new international research led by The University of Western Australia.
45 minutes ago | not rated yet | 0
More than half of patients diagnosed with Non-Hodgkin Lymphoma (NHL) are now surviving the disease thanks to improved diagnosis and treatment, according to a new report1 from Cancer Research UK.
19 minutes ago | not rated yet | 0
(Medical Xpress)—There is no significant risk directly associated with air travel during pregnancy, even at advanced gestation, says report by the University of Liverpool.
9 minutes ago | not rated yet | 0
To coincide with the broadcast of Jabbed: Love, Fear and Vaccines (SBS ONE, Sunday 26 May at 8.30pm) the first ever national survey on Australian attitudes to vaccination reveals surprising statistics including half of Australians ...
26 minutes ago | not rated yet | 0