ArticleBJPsych open2021
A retrospective examination of care pathways in individuals with treatment-resistant depression.
Article in BJPsych open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Clinical and cost-effectiveness of lithium versus quetiapine augmentation for treatment-resistant depression in adults: LQD a pragmatic randomised controlled trial.Health technology assessment (Winchester, England) · 2025Trial
- Examining the needs, outcomes and current treatment pathways of 2461 people with treatment-resistant depression: mixed-methods study.The British journal of psychiatry : the journal of mental science · 2026Article
- Treatment-Related Factors for Medication Non-Adherence Among Patients with Major Depressive Disorder: An Explanatory Sequential Mixed-Methods Study.Patient preference and adherence · 2026Article
- Impact of rural-urban residence and deprivation on care pathways for depression disorders among adults in the UK.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Exploring the ElectroRetinoGraphy as a biomarker for predicting and monitoring therapeutic response to antidepressants in major depressive disorder: study protocol for the MESANTIDEP trial.Frontiers in psychiatry · 2025Article
- The Psychiatric Association of Türkiye Depression Treatment Guidelines - I: Introduction, Terminology, Core Concepts, Assessment Methods.Turk psikiyatri dergisi = Turkish journal of psychiatry · 2025Review
- Evaluation of the impact of a 8 week exposure to a portable light therapy device, Luminette®, on retinal function assessed by ElectroRetinoGraphy.Current research in toxicology · 2025Article
- Care pathways, prescribing practices and treatment outcomes in major depressive disorder and treatment-resistant depression: retrospective, population-based cohort study.BJPsych open · 2024Article
- Commentary: Retinal electrophysiology in central nervous system disorders. A review of human and mouse studies.Frontiers in neuroscience · 2024Article
- Development of a model to predict antidepressant treatment response for depression among Veterans.Psychological medicine · 2023Article
- Evaluation, Treatment, and Referral of Treatment-Resistant Depression in Primary Care.The primary care companion for CNS disorders · 2023Article
- Setting national research priorities for difficult-to-treat depression in the UK between 2021-2026.Journal of global health · 2022Article
- The Downstaging Concept in Treatment-Resistant Depression: Spotlight on Ketamine.International journal of molecular sciences · 2022Review
- Care pathways for people with major depressive disorder: a European Brain Council Value of Treatment study.European psychiatry : the journal of the Association of European Psychiatrists · 2022Article
- Patient perspectives of lithium and quetiapine augmentation treatment in treatment-resistant depression: A qualitative assessment.Journal of psychopharmacology (Oxford, England) · 2022Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIndividuals with treatment-resistant depression (TRD) experience a high burden of illness. Current guidelines recommend a stepped care approach for treating depression, but the extent to which best-practice care pathways are adhered to is unclear.
aimsTo explore the extent and nature of 'treatment gaps' (non-adherence to stepped care pathways) experienced by a sample of patients with established TRD (non-response to two or more adequate treatments in the current depressive episode) across three cities in the UK.
methodFive treatment gaps were considered and compared with guidelines, in a cross-sectional retrospective analysis: delay to receiving treatment, lack of access to psychological therapies, delays to medication changes, delays to adjunctive (pharmacological augmentation) treatment and lack of access to secondary care. We additionally explored participant characteristics associated with the extent of treatment gaps experienced.
resultsOf 178 patients with TRD, 47% had been in the current depressive episode for >1 year before initiating antidepressants; 53% had received adequate psychological therapy. A total of 47 and 51% had remained on an unsuccessful first and second antidepressant trial respectively for >16 weeks, and 24 and 27% for >1 year before medication switch, respectively. Further, 54% had tried three or more antidepressant medications within their episode, and only 11% had received adjunctive treatment.
conclusionsThere appears to be a considerable difference between treatment guidelines for depression and the reality of care received by people with TRD. Future research examining representative samples of patients could determine recommendations for optimising care pathways, and ultimately outcomes, for individuals with this illness.
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