[How to define treatment-resistant depression?].

Quelle définition pour la dépression résistante ?

Jérôme Holtzmann (1, 2) , Raphaëlle Richieri (1, 3) , Ghassen Saba (1, 4) , Najib Allaïli (1, 5) , Rémy Bation (1, 6) , Fanny Moliere (1, 7) , Isabel Nieto (1, 5) , Frank Bellivier (1, 5) , Djamila Bennabi (1, 8) , Maxime Bubrovszky (1, 9) , Vincent Camus (1, 10) , Thomas Charpeaud (1, 11) , Pierre Courvoisier (1, 2) , Frédéric Haesebaert (1, 6) , Olivier Doumy (1, 12) , Philippe Courtet (1, 7, 13) , Wissam El-Hage (1, 10) , Marion Garnier (1, 11) , Thierry d'Amato (1, 6) , Christophe Lançon (1, 3) , Marion Leboyer (1, 4) , Pierre-Michel Llorca (1, 11) , Guillaume Vaiva (1, 9) , Thierry Bougerol (1, 2) , Bruno Aouizerate (1, 12) , Emmanuel Haffen (1, 8)

1 Fondation FondaMental [Créteil]
2 Pôle Psychiatrie et Neurologie [Grenoble]
3 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
4 Pôle de Psychiatrie [Hôpital Henri Mondor]
5 Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris]
6 Centre Hospitalier le Vinatier [Bron]
7 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
8 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
9 Service de Psychiatrie [CHRU Lille]
10 Clinique Psychiatrique Universitaire [Tours]
11 CHU Clermont-Ferrand
12 Centre hospitalier Charles Perrens [Bordeaux]
13 PSNREC - Neuropsychiatrie : recherche épidémiologique et clinique

The most largely used definition of the treatment-resistant depression relies on the failure of two successive trials of antidepressant treatment at an adequate dose and duration. The absence of response to previous antidepressant treatments should be assessed using specific and appropriate clinical instruments enabling a correct staging of the therapeutic resistance. A wide range of socio-demographic and clinical factors (i.e. psychiatric/somatic comorbidities) are classically associated with the therapeutic resistance. The aim of the treatment of major depression is to achieve a complete clinical remission. The presence of residual symptoms increases the risk for the subsequent occurrence of relapses and recurrences, hence facilitating the development of therapeutic resistance. The treatment-resistant depression has a deleterious impact on the social, familial or professional functioning, thereby leading to an impaired quality of life with serious socioeconomic consequences and costs.

Domaines: Médecine humaine et pathologie

Jérôme Holtzmann, Raphaëlle Richieri, Ghassen Saba, Najib Allaïli, Rémy Bation, et al.. Quelle définition pour la dépression résistante ?. La Presse Médicale, 2016, 45 (3), pp.323 - 328. ⟨10.1016/j.lpm.2016.02.002⟩. ⟨hal-01872821⟩