A proposed clinical approach to chronic and «resistant» depressions: evaluation and treatment

摘要: Many patients referred to specialized affective disorder units in the 1970s because of chronicity, treatment resistance, or failure were found have been inadequately treated--most typically with suboptimal trials one two tricyclic antidepressants (TCAs). In 1980s, are being declared "treatment failures" following a more sophisticated range efforts. part, change can be attributed systematic feedback provided by mood clinics referring clinicians and nationwide educational Terminologic conceptual issues reviewed, chronicity disorders examined from multifactorial perspective involving pharmacokinetic factors, patient compliance, adequacy somatic treatments, physician countertransference, social interpersonal aspects, nosologic considerations, medical-neurologic contributions. A approach for evaluating treating such is outlined.