Join Hamish McAllister-Williams, PhD, MD, FRCPsych, Professor of Affective Disorders, Senior Research Advisor, Newcastle University; Deputy Medical Director for Research, Cumbria, Northumberland, Tyne, and Wear NHS Foundation Trust (CNTW), for a free Grand Rounds lecture.
Overview:
Treatment-resistant depression (TRD) is understood to mean a patient's depression doesn't respond to two consecutive adequate trials of different antidepressants. But the term raises a question about what or who is truly "resistant." TRD concentrates on non-response, ignoring other equally challenging scenarios like a lack of sustained response, intolerance to treatment, or situations where treatment isn't accepted. Difficult-to-treat depression (DTD) offers a more clinically oriented concept of depression with unfavorable outcomes. It describes depression that persists as a burden for the patient despite standard clinical treatment efforts. Crucially, DTD adopts a chronic care model rather than an acute one. It emphasizes holistic, personalized management that identifies factors contributing to the poor outcome and explores ways to address them. While the primary treatment goal is symptom remission, that can be particularly hard to achieve for some. In those cases, the focus may shift towards effectively managing lingering symptoms and enhancing psychosocial functioning and quality of life. This presentation will explore systematic approaches to managing DTD using the DTD care model. The aim isn't just to improve symptoms but also to reduce relapse risks and enhance overall quality of life for patients.
Learning Objectives:
At the conclusion of this lecture, attendees will be able to:
- Describe the components of the DTD management model.
- Demonstrate an ability to review a patient’s pharmacotherapy systematically.
- Explain the components necessary for an “individualized algorithmic approach” to treatment.
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