Pharmacological interventions for treatment-resistant depression in adults

Davies, Philippa; Ijaz, Sharea; Williams, Catherine J.; Keßler, David; Wiles, Nicola

doi:10.1002/14651858.cd010557.pub2

Cited by 42 publications

(33 citation statements)

References 202 publications

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“…The expansion of approved indications for atypical antipsychotics which include disorders without psychosis as a feature, such as major depressive disorder, has resulted in a significant increase in their use (Stoner 2017). Even though psychiatric symptoms may necessitate augmentation with atypical antipsychotics (Davies et al 2019), their potential to cause metabolic side effects, such as rapid weight gain and diabetes (Abosi et al . 2018), should be carefully considered alongside possible improvements in psychiatric symptomatology.…”

Section: Discussionmentioning

confidence: 99%

Physical comorbidities in private psychiatric inpatients: Prevalence and its association with quality of life and functional impairment

Nadjidai

Kusljic

Dowling

et al. 2020

Int J Mental Health Nurs

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The aim of this study was to examine the association between physical health conditions and quality of life and functioning in private psychiatric inpatients. We sought to determine whether quality of life and functioning was poorer in individuals with physical comorbidity compared to those without. A quantitative correlational descriptive design was utilized. Seventy patients were included in sequential order within a week of admission to hospital. Participants completed the SF‐36 survey, and the corresponding hospital records were audited. The STROBE guidelines were followed in the reporting of this research. The study found that 64.3% (45/70) of participants had one or more comorbid physical health conditions, primarily cardiovascular, respiratory, musculoskeletal, endocrine and medically unexplained conditions or syndromes. Chronic pain was experienced by 40% (28/70) of participants, and 47.6% (33/70) were found to be overweight or obese. Tobacco smoking and obesity were risk factors associated with physical comorbidity (P = 0.02 and P < 0.001, respectively). Quality of life and functioning were poorer in those with physical health conditions, particularly in the SF‐36 domains of bodily pain, physical functioning and general health (P < 0.001, P = 0.003 and P = 0.005, respectively). Physical health conditions were largely prevalent, and quality of life and functioning were poorer in those with physical comorbidities. The implementation of clinical guidelines for the monitoring of physical health has been proposed as well as a dedicated physical health nursing role. Continuation of integrative programmes focusing on both physical and mental health may also benefit patients in this setting.

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Section: Discussionmentioning

confidence: 99%

Physical comorbidities in private psychiatric inpatients: Prevalence and its association with quality of life and functional impairment

Nadjidai

Kusljic

Dowling

et al. 2020

Int J Mental Health Nurs

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“…We will include studies that enrolled patients who had a disease history of TBI as well as were confirmedly primary diagnosed with depressive disorder, or had clinically significant depressive symptoms, based on at least one of the standardized international or domestic authorized diagnostic criteria or guidelines for clinical research such as Feighner criteria, Research Diagnostic Criteria, Diagnostic and Statistical Manual of Mental Disorders 3rd edition (DSM-III), 3rd revised edition (DSM-III-R), 4th edition (DSM-IV), 5th edition (DSM-5), and International Classification of Diseases10th revision (ICD-10), etc. [ 32 – 34 ] We will not apply restrictions with regard to any information about age, sex, race, education status, nationality, economic status, severity, and duration of disease, etc. A concurrent secondary diagnosis of another psychiatric disorder after TBI will not be considered as an exclusion criterion, but studies in which all patients have a concurrent primary diagnosis of another Axis I or II disorder will be excluded.…”

Section: Methods and Analysismentioning

confidence: 99%

Non-pharmacological interventions for depressive disorder in patients after traumatic brain injury

Guo²,

Wei

et al. 2020

Medicine

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Background: Depressive disorder has gradually become one of the most commonly reported disabling psychiatric complication that occurs after traumatic brain injury (TBI). Currently classical antidepressant medications may not have the same effectiveness in patients with TBI as in patients without TBI. Non-pharmacological interventions have been considered to be effective for managing depressive symptoms or treating depressive disorder. But to date the comparative effectiveness of various types of non-pharmacological interventions has been synthesized in few studies, the evidence remains inconclusive. Thus, the purpose of this systematic review and network meta-analyses is to summarize high-quality evidence and identify the most effective non-pharmacological intervention when applied to treat the depressive disorder in patients after TBI. Methods: The comprehensive literature search in electronic database including PubMed, Ovid Medline, Cochrane Library, Web of Science database, Embase Database, China National Knowledge Infrastructure (CNKI), and Wanfang Data Chinese database from inception to the search date. Only high-quality randomized controlled trials (RCTs) that have used non-pharmacological interventions to treat depressive disorder after TBI will be considered. Two independent reviewers will identify eligible studies, extract and manage data information, and then determine methodical quality of included studies. Overall efficacy will be assessed as primary outcome. Secondary outcomes involved treatment response, remission rate, overall acceptability, tolerability of treatment, social functioning, occurrence of adverse events, and suicide-related outcome. Cochrane risk of bias assessment tool will be adopted to assess the risk of bias. Study heterogeneity will be measured by the I 2 statistic. Traditional pairwise meta-analyses will be performed using STATA, while WinBUGS with GeMTC package of R software will be used to carry out network meta-analysis. Results: This systematic review will examine the relative efficacy, effectiveness, safety, tolerability and acceptability of non-pharmacological interventions, and then to identify the most effective non-pharmacological intervention for depressive disorder after TBI. Expected conclusion: Our work could be used to give clinical recommendations for practice guideline developers, psychiatrist, neurologist, policymakers, researchers as well as individual with depressive disorder after TBI, and will also identify gaps in knowledge that could be the subject of future research. Ethics and dissemination: Neither ethics approval nor patient informed consent is necessary since this protocol was designed based on the existing literature. The results will be disseminated electronically or in print through publications in peer-reviewed scientific journal. INPLASY reg...

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“…One example is patients with treatment-resistant depression, which has been operationalized as a lack of response or remission following two or more adequate courses of treatment [ 90 ]. The literature on treatment-resistant depression is limited, with some support for antidepressant augmentation and adjunctive psychotherapy [ 91 , 92 ]. Even fewer studies have been conducted in the primary care setting [ 93 – 95 ], resulting in uncertainty over what may be the most effective practices.…”

Section: Challenges Of Treating Depression In the Pcmhmentioning

confidence: 99%

The Role of the Patient-Centered Medical Home in Treating Depression

Bogucki

Williams

Solberg

et al. 2020

Curr Psychiatry Rep

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Purpose of Review This review discusses the role of the patient-centered medical home (PCMH) in treating depression, focusing on findings from primary care-based studies and their implications for the PCMH. Recent Findings Pharmacotherapy, psychotherapy, and collaborative care are evidence-based treatments for depression that can be delivered in primary care and extended to diverse populations. Recent research aligns with the core components of the PCMH model. Summary The core components of the PCMH are critical elements of depression treatment. Comprehensive care within the PCMH addresses medical and behavioral health concerns, including depression. Psychiatric and psychological care must be flexibly delivered so services remain accessible yet patient-centered. To ensure the quality and safety of treatment, depression symptoms must be consistently monitored. Coordination within and occasionally outside of the PCMH is needed to ensure patients receive the appropriate level of care. More research is needed to empirically evaluate depression treatment within the PCMH.

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Pharmacological interventions for treatment-resistant depression in adults

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 42 publications

References 202 publications

Physical comorbidities in private psychiatric inpatients: Prevalence and its association with quality of life and functional impairment

Physical comorbidities in private psychiatric inpatients: Prevalence and its association with quality of life and functional impairment

Non-pharmacological interventions for depressive disorder in patients after traumatic brain injury

The Role of the Patient-Centered Medical Home in Treating Depression

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