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2016-03-09 发布于山东
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John G. Tierney II, MD M.pdf

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Treatment-Resistant Depression: Managed Care Considerations John G. Tierney II, MD ABSTRACT ajor depressive disorder (MDD) is the second most common psychiatric disorder in the United States.1 BaCkgRounD: Treatment-resistant depression (TRD) presents a unique MThe lifetime prevalence for major depression appears challenge in managed care, requiring review of both the clinical and economic 2,3 components of care. to be between 6% and 16%. While the etiology of depression is not fully understood, evidence suggests that depression is oBjeCTive: To review the TRD disease state as well as data supporting the various therapeutic options available for the treatment of persistent the result of a complex interaction among biological, genetic, depression in managed care. psychosocial, and environmental factors.4,5 SuMMaRy: While there is no consensus on the definition of TRD, persistent The Diagnostic and Statistical Manual, Fourth Edition, Text disease can generally be defined as depression that fails to respond to Revision (DSM-IV-TR) outlines common signs and symptoms of adequate treatment. When initial treatment is not effective or tolerable after a major depressive episode.6 While not a definitive list, the 6 to 8 weeks of therapy, the ame