Limandri Barbara J
J Psychosoc Nurs Ment Health Serv. 2018 Sep 1;56(9):11-15. doi: 10.3928/02793695-20180808-01.
Treatment-resistant depression (TRD) refers to depression that fails to remit after at least two to four medication and psychotherapy treatment strategies. TRD carries significant personal burden and risk for suicide and poses substantial burden to society. Less than 30% of individuals diagnosed with major depressive disorder achieve complete remission of symptoms. Using the evidence-based predictors of TRD in the initial assessment of patients, clinicians can arrive at a treatment plan to improve outcomes. The current article includes first-line medications based on symptom presentation as well as augmentation and more aggressive treatment recommendations for patients who continue to experience depressive symptoms beyond 6 months of effective dose and time trials of treatment. [Journal of Psychosocial Nursing and Mental Health Services, 56(9), 11-15.].
难治性抑郁症（TRD）是指在至少采用两种至四种药物及心理治疗策略后仍未缓解的抑郁症。TRD给患者带来巨大的个人负担和自杀风险，也给社会造成沉重负担。被诊断为重度抑郁症的患者中，症状完全缓解的比例不到30%。在对患者进行初始评估时，临床医生利用基于证据的TRD预测指标，可制定出改善治疗效果的治疗方案。本文介绍了根据症状表现的一线用药，以及针对在有效剂量和治疗时间试验6个月后仍持续出现抑郁症状的患者的强化治疗和更积极的治疗建议。[《心理社会护理与心理健康服务杂志》，56(9)，11 - 15。]
