Malhi Gin S, Byrow Yulisha
Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Sydney, New South Wales, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Kolling Institute, Northern Clinical School, University of Sydney, Sydney, New South Wales, Australia.
Department of Psychiatry, CADE Clinic, Royal North Shore Hospital, Sydney, New South Wales, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia;
Evid Based Ment Health. 2016 Feb;19(1):1-3. doi: 10.1136/eb-2015-102299. Epub 2016 Jan 14.
The term treatment-resistant depression (TRD) is widely used in the context of managing mood disorders, but defining it, both conceptually and in practice, has proven difficult. Most definitions have focused on pharmacotherapy but even these have struggled to capture the complexity of varying response and duration of treatment. Both clinically and for research studies a meaningful definition of TRD is necessary because it may lead to the development of 'therapy-defined depressive subtypes' and the discovery of novel antidepressants. This brief perspective critically reviews the concept of treatment resistance and how it can be more clearly defined so as to achieve a better understanding of depression and facilitate clinical treatment trials.
难治性抑郁症（TRD）这一术语在情绪障碍管理领域被广泛使用，但事实证明，无论在概念上还是实践中，对其进行定义都很困难。大多数定义都集中在药物治疗上，但即便如此，这些定义仍难以涵盖治疗反应和治疗持续时间的复杂性。无论是在临床还是研究层面，对TRD进行有意义的定义都是必要的，因为这可能会促成“治疗定义的抑郁亚型”的形成以及新型抗抑郁药的发现。这篇简短的观点性文章批判性地审视了治疗抵抗的概念以及如何能更清晰地定义它，以便更好地理解抑郁症并推动临床试验。
