Prospective evaluation of specialist inpatient treatment for refractory affective disorders

Inflammatory profiles of severe treatment-resistant depression

“…TRD patients' depression severity was examined using the HAMD at admission, discharge and a follow-up assessment 3-12 months after discharge (long-term outcome). The follow-up assessment may more accurately reflect everyday wellbeing following the treatment program, while at discharge HAMD scores could dip due to life disruption occurring in the period surrounding this (Wooderson et al, 2011). Shortterm response was defined as HAMD score reduction of >50% between admission and discharge, or if criteria for remission were met (HAMD score <8).…”

“…Patients with treatment resistant depression (TRD) frequently do not respond to numerous treatments and present with chronic, debilitating mood disorders that are often comorbid with many physical and mental illnesses (Fekadu et al, 2009a). Despite this serious problem, evidence now suggests that even the most treatment-resistant patients can achieve sustained remission with a highly specialist, multidisciplinary, intensive and careful intervention program (Wooderson et al, 2014(Wooderson et al, , 2011. Elucidating a set of factors that predicts response to treatment will be key to optimising individualised treatment choices in both bipolar and unipolar depressive disorders, and for identifying potential new targets for novel interventions (Gadad et al, 2018;Strawbridge et al, 2017).…”

Continuity Across Inpatient and Outpatient Mental Health Care or Specialisation of Teams? A Systematic Review

“…This may suggest benefits to having separate inpatient and outpatient care during acute or early stages of the illness. Indeed, a specialisation system may favour the development of expertise for the intensive treatment of specific patient groups by focusing on one treatment setting, e. g. specialized inpatient care for patients who have treatment-resistant disorders [41]. Additionally, patients who have a limited range of needs, not requiring the coordination of different interventions for their care, may benefit from the higher specialisation of care that can be achieved from separate inpatient and outpatient services, and from the opportunity to meet different clinicians and to receive second opinions [24].…”

Avaliação da resposta terapêutica de pacientes depressivos com estresse precoce: uma perspectiva da terapia ocupacional

“…Ao analisarmos as características clínicas da amostra, encontramos um predomínio de pacientes com diagnóstico de depressão unipolar, com média da idade do episódio depressivo atual de 41.0 anos. A pesquisa conduzida por Wooderson et al (2011), encontrou um predomínio em torno de 75% da amostra composta por pacientes com depressão unipolar, além do início da doença estar em torno dos 40 anos, diferindo do achado do nosso estudo, já que a média da idade de início da doença dos nossos pacientes foi de 28.6 anos e duração média da doença de 12.7 anos. Nesse sentido, a literatura científica aponta que a probabilidade de resposta ao tratamento farmacológico está intimanente associada com a idade de início da doença depressiva, sendo que quanto mais precoce for o início do aparecimento da doença, menor é a chance de resposta terapêutica (Thase, 1996 Scharag et al, 2008;Chapman & Perry, 2008;Mulder, 2002).…”