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Difficult-to-treat-depression: what do general practitioners think?

This is a republished version of an article previously published in MJA Open

The social, economic and personal burdens caused by depression are substantial1 and well documented.2 Nonetheless, shortcomings in treatment of depression have been identified in both primary and specialised care, with respect to diagnosis, management and patient adherence.

Health professionals, including general practitioners, may be confused about diagnosis and management when clear definitions and acceptable taxonomy cannot be found. In the literature, terms including “difficult-to-treat depression”, “treatment-resistant depression”, “treatment-refractory depression”, “treatment-resistant major depressive disorder” and “major depressive disorder” are often used interchangeably,35 resulting in considerable confusion. Further problems arise because of a mismatch between current classification systems, such as the Diagnostic and statistical…