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

Cultural values can be a strong predictor of alcohol consumption

November 20, 2017
Countries with populations that value autonomy and harmony tend to have higher average levels of alcohol consumption than countries with more traditional values, such as hierarchy and being part of a collective. This new ...

A walk at the mall or the park? New study shows, for moms and daughters, a walk in the park is best

November 17, 2017
Spending time together with family may help strengthen the family bond, but new research from the University of Illinois shows that specifically spending time outside in nature—even just a 20-minute walk—together can ...

Risk of distracted driving predicted by age, gender, personality and driving frequency

November 17, 2017
New research identifies age, gender, personality and how often people drive as potential risk factors for becoming distracted while driving. Young men, extroverted or neurotic people, and people who drive more often were ...

When male voles drink alcohol, but their partner doesn't, their relationship suffers

November 17, 2017
A study of the effect of alcohol on long-term relationships finds that when a male prairie vole has access to alcohol, but his female partner doesn't, the relationship suffers - similar to what has been observed in human ...

Spanking linked to increase in children's behavior problems

November 16, 2017
Children who have been spanked by their parents by age 5 show an increase in behavior problems at age 6 and age 8 relative to children who have never been spanked, according to new findings in Psychological Science, a journal ...

Multiplayer video games: Researchers discover link between skill and intelligence

November 15, 2017
Researchers at the University of York have discovered a link between young people's ability to perform well at two popular video games and high levels of intelligence.

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.