Definition of treatment-resistant depression - Asia Pacific perspectives

JOURNAL OF AFFECTIVE DISORDERS

卷:245

Review

Ng, C. H.¹  Kato, T.²  Han, C.³  Wang, G.⁴  Trivedi, M.⁵  Ramesh, V.⁶  Shao, D.⁶  Gala, S.⁶  Narayanan, S.⁶  Tan, W.⁷  Feng, Y.⁷  Kasper, S.⁸ 

[1] Univ Melbourne, Dept Psychiat, Melbourne, Vic, Australia

[2] RIKEN Brain Sci Inst, Saitama, Japan

[3] Korea Univ, Seoul, South Korea

[4] Capital Med Univ, Anding Hosp, Beijing, Peoples R China

[5] Univ Texas Southwestern Med Ctr, Dallas, TX USA

[6] Market Access Solut LLC, Raritan, NJ USA

[7] Janssen Asia Pacific, Singapore, Singapore

[8] Med Univ Vienna, Vienna, Austria

关键词: Treatment resistant depression;    Asia-pacific;    Definition;    Consensus;    Systematic literature review;    Expert panel;   

DOI  :  10.1016/j.jad.2018.11.038

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

Free