The definition and meaning of treatment-resistant depression.
The definition and meaning of treatment-resistant depression.
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发表时间：
2001
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通讯作者：
H. Sackeim
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作者：
H. Sackeim
大多数接受单相或双相重性抑郁发作治疗的患者是治疗抵抗性的，因为大多数患者在接受第一次躯体或心理治疗后没有达到完全缓解。很少有人注意到正式标准的性质和程度的治疗耐药性的评价，即使确定充分性和结果的先前的治疗试验是关键的临床决策有关后续治疗。此外，确定先前治疗的充分性是至关重要的，因为大量证据表明，大量抑郁症患者治疗不足，导致长期发作和出现“假抵抗”。“抗抑郁药治疗试验的可靠性应该根据药物剂量和持续时间的阈值，依从性和临床结果来定义。抗抑郁药治疗史表是一种正式评价治疗充分性和治疗耐药性的方法。
Most patients treated for an episode of unipolar or bipolar major depression are treatment resistant in the sense that the majority do not achieve full remission with the first somatic or psychosocial treatment they receive. Little attention has been given to formalizing criteria for evaluating the nature and extent of treatment resistance, even though determining the adequacy and outcome of prior treatment trials is key in clinical decision making about subsequent treatment. Furthermore, determining the adequacy of prior treatment is essential since substantial evidence indicates that large numbers of depressed patients are undertreated, resulting in prolonged episodes and the appearance of "pseudoresistance." Adequacy of antidepressant treatment trials should be defined in terms of thresholds for the dosage and duration of medication, adherence, and clinical outcome. The Antidepressant Treatment History Form is presented as one method to formalize the evaluation of treatment adequacy and treatment resistance.