[Treatment-resistant depression: state of the art. Part I. Nosography and clinic].

AIMS: This work would give an overall vision of the actual knowledge about nosography and clinic of treatment-resistant depression.

METHOD: A PubMed, PsychInfo, Google Scolar search was done using the key words "resistant depression", "STAR*D", "bipolar depression", "staging". Have been selected exclusively works in English, French and Italian languages.

RESULTS

Treatment-resistant depression is one of the most important problem in public health. Nevertheless a general consensus about its definition and staging does not exist at now. Principal risk factors and associated comorbidities are well known including the association with bipolar spectrum; anyway the disease particularly common among depressed outpatients is still very disabling, responsible of an often chronic course, with numerous relapses and high risk of suicide.

DISCUSSION AND

CONCLUSION

The future investigations, once improved procedures for differential diagnosis and subtyping of clinical depression, should be directed to the search of a shared definition of treatment resistance and the development of specific therapeutic protocols.