Definition of treatment-resistant depression - Asia Pacific perspectives
- Authors
- Ng, C. H.; Kato, T.; Han, C.; Wang, G.; Trivedi, M.; Ramesh, V.; Shao, D.; Gala, S.; Narayanan, S.; Tan, W.; Feng, Y.; Kasper, S.
- Issue Date
- 15-2월-2019
- Publisher
- ELSEVIER SCIENCE BV
- Keywords
- Treatment resistant depression; Asia-pacific; Definition; Consensus; Systematic literature review; Expert panel
- Citation
- JOURNAL OF AFFECTIVE DISORDERS, v.245, pp.626 - 636
- Indexed
- SCIE
SSCI
SCOPUS
- Journal Title
- JOURNAL OF AFFECTIVE DISORDERS
- Volume
- 245
- Start Page
- 626
- End Page
- 636
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/67629
- DOI
- 10.1016/j.jad.2018.11.038
- ISSN
- 0165-0327
- Abstract
- Background: The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. Methods: A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010-2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. Results: Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: (3) 1 to (3) 3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4-12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to (3) 2 antidepressant therapies given at adequate doses, for 6-8 weeks during a major depressive episode. Limitations: Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. Conclusion: Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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