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Hi everyone. If you're being treated for depression and haven't responded

well to the therapy, you're not alone -- according to new study. (Of course

there is always a " new study " to confuse us just a little more -- lol).

I found this study particularly interesting, though, since I was one who

never responded to treatment for depression, and since I am one who thinks

AntiD's

made my symptoms of chronic fatigue and mental status changes worse.

http://www.reuters.com/newsChannel.jhtml?type=healthNews

Health - Reuters

Many Fail to Recover with Depression Treatment

Mon May 31, 2004, 11:55 AM ET

By Amy Norton

NEW YORK (Reuters Health) -

Many people who receive standard therapy for

depression still suffer from the condition up to two years after starting

treatment, a new study suggests.

The study, which involved more than 1,200 patients diagnosed with depression

at 46 U.S. primary care centers, found that nearly half of those who

received " at least minimally appropriate " depression treatment did not

improve.

Minimally appropriate care meant that over a six-month period, patients had

at least four therapy sessions or spent two months or more on

antidepressants. Of patients in the study, 542 received at least this level

of care; however, 261 of them failed to recover after two rounds of

minimally appropriate treatment.

The findings show that despite the availability of therapies that have been

proven effective, there remains a group of patients with particularly

hard-to-treat depression, according to Dr. Sherbourne of the

research organization RAND Corporation in Santa , California.

" What we need is more research on the most effective way to treat this

group, " Sherbourne told Reuters Health.

She and her colleagues report their findings in the journal General Hospital

Psychiatry.

While fewer than half of all patients in the study received what the

researchers deemed minimally adequate care, lack of trying does not seem to

explain the nearly 50-percent rate of non-response among patients who did

get this level of care.

According to Sherbourne's team, patients with persistent depression appeared

to be receiving more-aggressive treatment -- with, for example, 15 percent

being prescribed both drugs and therapy during each of the three six-month

periods the study assessed. That compares with only three percent of

patients who did respond to treatment.

It seems, the researchers write, that patients with persistent depression

and their doctors " were searching for solutions. "

Still, according to Sherbourne, it may be that more of these patients need a

combination of medications and therapy, ongoing assessments by their

doctors, or referrals to specialists.

The researchers also found that three patient characteristics made treatment

failure more likely: suicidal thoughts, unemployment and lack of adherence

to medication.

Suicidal thoughts denote more severe depression, Sherbourne explained, and

lack of work could be a sign of poor functioning in daily life. As for

non-compliance with drugs, she noted, side effects are often to blame when

patients stop taking their medication before they should.

All of these factors could make a person's depression particularly hard to

treat, according to Sherbourne.

Doctors should be " alert " for the broad range of factors from mental and

physical health to daily life stress, she and her colleagues conclude, which

could affect depression treatment.

SOURCE: General Hospital Psychiatry, March-April 2004.

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Guest guest

Hi everyone. If you're being treated for depression and haven't responded

well to the therapy, you're not alone -- according to new study. (Of course

there is always a " new study " to confuse us just a little more -- lol).

I found this study particularly interesting, though, since I was one who

never responded to treatment for depression, and since I am one who thinks

AntiD's

made my symptoms of chronic fatigue and mental status changes worse.

http://www.reuters.com/newsChannel.jhtml?type=healthNews

Health - Reuters

Many Fail to Recover with Depression Treatment

Mon May 31, 2004, 11:55 AM ET

By Amy Norton

NEW YORK (Reuters Health) -

Many people who receive standard therapy for

depression still suffer from the condition up to two years after starting

treatment, a new study suggests.

The study, which involved more than 1,200 patients diagnosed with depression

at 46 U.S. primary care centers, found that nearly half of those who

received " at least minimally appropriate " depression treatment did not

improve.

Minimally appropriate care meant that over a six-month period, patients had

at least four therapy sessions or spent two months or more on

antidepressants. Of patients in the study, 542 received at least this level

of care; however, 261 of them failed to recover after two rounds of

minimally appropriate treatment.

The findings show that despite the availability of therapies that have been

proven effective, there remains a group of patients with particularly

hard-to-treat depression, according to Dr. Sherbourne of the

research organization RAND Corporation in Santa , California.

" What we need is more research on the most effective way to treat this

group, " Sherbourne told Reuters Health.

She and her colleagues report their findings in the journal General Hospital

Psychiatry.

While fewer than half of all patients in the study received what the

researchers deemed minimally adequate care, lack of trying does not seem to

explain the nearly 50-percent rate of non-response among patients who did

get this level of care.

According to Sherbourne's team, patients with persistent depression appeared

to be receiving more-aggressive treatment -- with, for example, 15 percent

being prescribed both drugs and therapy during each of the three six-month

periods the study assessed. That compares with only three percent of

patients who did respond to treatment.

It seems, the researchers write, that patients with persistent depression

and their doctors " were searching for solutions. "

Still, according to Sherbourne, it may be that more of these patients need a

combination of medications and therapy, ongoing assessments by their

doctors, or referrals to specialists.

The researchers also found that three patient characteristics made treatment

failure more likely: suicidal thoughts, unemployment and lack of adherence

to medication.

Suicidal thoughts denote more severe depression, Sherbourne explained, and

lack of work could be a sign of poor functioning in daily life. As for

non-compliance with drugs, she noted, side effects are often to blame when

patients stop taking their medication before they should.

All of these factors could make a person's depression particularly hard to

treat, according to Sherbourne.

Doctors should be " alert " for the broad range of factors from mental and

physical health to daily life stress, she and her colleagues conclude, which

could affect depression treatment.

SOURCE: General Hospital Psychiatry, March-April 2004.

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