Treating stubborn depression

October 3, 2012

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.

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 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, with the University of 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 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 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".

Explore further: Speech a new marker for depression treatment response

Related Stories

Speech a new marker for depression treatment response

August 13, 2012
(Medical Xpress) -- Speech can measure the severity of depression as well as a patient’s response to treatment, a new collaborative study between the University of Melbourne and the Center for Psychological Consultation ...

Looking at links between depression and insomnia

February 27, 2012
People with both insomnia and depression who have found anti-depressants ineffective can draw hope from a new study currently recruiting in Melbourne.

Online treatment dramatically cuts suicide risk

September 18, 2012
(Medical Xpress)—Australian research, published in the British Medical Journal Open, shows a dramatic reduction in both depression and suicidal thoughts in patients who participated in a study involving internet cognitive ...

Treating depression one step at a time

July 1, 2011
(Medical Xpress) -- One in six people worldwide will experience depression over the course of a lifetime. This alarming fact has led to recent research by Dr. Paul Biegler from the Center for Human Bioethics at Monash University. ...

Recommended for you

Suicidal thoughts rapidly reduced with ketamine, finds study

December 14, 2017
Ketamine was significantly more effective than a commonly used sedative in reducing suicidal thoughts in depressed patients, according to researchers at Columbia University Medical Center (CUMC). They also found that ketamine's ...

Do bullies have more sex?

December 14, 2017
Adolescents who are willing to exploit others for personal gain are more likely to bully and have sex than those who score higher on a measure of honesty and humility. This is according to a study in Springer's journal Evolutionary ...

Children's screen-time guidelines too restrictive, according to new research

December 14, 2017
Digital screen use is a staple of contemporary life for adults and children, whether they are browsing on laptops and smartphones, or watching TV. Paediatricians and scientists have long expressed concerns about the impact ...

Eating together as a family helps children feel better, physically and mentally

December 14, 2017
Children who routinely eat their meals together with their family are more likely to experience long-term physical and mental health benefits, a new Canadian study shows.

The iceberg model of self-harm

December 14, 2017
Researchers have created a model of self-harm that shows high levels of the problem in the community, especially in young girls, and the need for school-based prevention measures.

Encouraging risk-taking in children may reduce the prevalence of childhood anxiety

December 13, 2017
A new international study suggests that parents who employ challenging parent behavioural (CPB) methods – active physical and verbal behaviours that encourage children to push their limits – are likely protecting their ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.