A model for the management of difficult to treat depression
In this presentation a model for the management of difficult to treat depression (DTD) will be presented based upon a recently published international consensus statement (McAllister-Williams et al. 2020 Journal of Affective Disorders 267:264-282). This model emphasises the goals of: optimal symptom...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382100136X/type/journal_article |
| _version_ | 1797617503428411392 |
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| author | H. Mcallister-Williams |
| author_facet | H. Mcallister-Williams |
| author_sort | H. Mcallister-Williams |
| collection | DOAJ |
| description | In this presentation a model for the management of difficult to treat depression (DTD) will be presented based upon a recently published international consensus statement (McAllister-Williams et al. 2020 Journal of Affective Disorders 267:264-282). This model emphasises the goals of: optimal symptom control – remission if possible; optimisation of psychosocial functioning; and optimisation of prophylaxis against relapse/deterioration in mood. Building on these goals, the model follows a number of principles. These include emphasizing the importance of shared decision making and measurement-based care, enhancing engagement and retention in services, self-management strategies and frequent re-assessments, all incorporated in an integrated service pathway. The model itself encompasses eight elements: 1. Optimal symptom control using conventional, guideline recommended, treatments but moving on to treatments beyond guidelines in an appropriate and timely way; 2. Targeting symptoms associated with poor outcomes, e.g. anxiety and pain; 3. Targeting symptoms associated with poor functioning and quality of life such as sleep difficulties, fatigue and cognitive dysfunction; 4. Screening for and managing physical, psychiatric, substance misuse and iatrogenic comorbidities; 5. Optimisation of long-term treatment; 6. Using self-management techniques to empower patients; 7. Using integrated health services to help provide a sense of containment and ensure wide consideration of treatment options; and 8. Establishing regular reviews of the patient’s diagnosis and treatment. Examples of each of these elements will be provided. |
| first_indexed | 2024-03-11T07:57:01Z |
| format | Article |
| id | doaj.art-a412a825be1a477ca51e497cc4d4a8f7 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:57:01Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-a412a825be1a477ca51e497cc4d4a8f72023-11-17T05:05:29ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S40S4110.1192/j.eurpsy.2021.136A model for the management of difficult to treat depressionH. Mcallister-Williams0Mental Health, Dementia And Neurodegenerative Disorders, Newcastle University, Newcastle, United KingdomIn this presentation a model for the management of difficult to treat depression (DTD) will be presented based upon a recently published international consensus statement (McAllister-Williams et al. 2020 Journal of Affective Disorders 267:264-282). This model emphasises the goals of: optimal symptom control – remission if possible; optimisation of psychosocial functioning; and optimisation of prophylaxis against relapse/deterioration in mood. Building on these goals, the model follows a number of principles. These include emphasizing the importance of shared decision making and measurement-based care, enhancing engagement and retention in services, self-management strategies and frequent re-assessments, all incorporated in an integrated service pathway. The model itself encompasses eight elements: 1. Optimal symptom control using conventional, guideline recommended, treatments but moving on to treatments beyond guidelines in an appropriate and timely way; 2. Targeting symptoms associated with poor outcomes, e.g. anxiety and pain; 3. Targeting symptoms associated with poor functioning and quality of life such as sleep difficulties, fatigue and cognitive dysfunction; 4. Screening for and managing physical, psychiatric, substance misuse and iatrogenic comorbidities; 5. Optimisation of long-term treatment; 6. Using self-management techniques to empower patients; 7. Using integrated health services to help provide a sense of containment and ensure wide consideration of treatment options; and 8. Establishing regular reviews of the patient’s diagnosis and treatment. Examples of each of these elements will be provided.https://www.cambridge.org/core/product/identifier/S092493382100136X/type/journal_articleTreatment Resistant DepressionDifficult to treat depressionDepression |
| spellingShingle | H. Mcallister-Williams A model for the management of difficult to treat depression European Psychiatry Treatment Resistant Depression Difficult to treat depression Depression |
| title | A model for the management of difficult to treat depression |
| title_full | A model for the management of difficult to treat depression |
| title_fullStr | A model for the management of difficult to treat depression |
| title_full_unstemmed | A model for the management of difficult to treat depression |
| title_short | A model for the management of difficult to treat depression |
| title_sort | model for the management of difficult to treat depression |
| topic | Treatment Resistant Depression Difficult to treat depression Depression |
| url | https://www.cambridge.org/core/product/identifier/S092493382100136X/type/journal_article |
| work_keys_str_mv | AT hmcallisterwilliams amodelforthemanagementofdifficulttotreatdepression AT hmcallisterwilliams modelforthemanagementofdifficulttotreatdepression |