Treatment-resistant major depression and bipolar disorder are highly prevalent and disabling conditions associated with substantial morbidity and mortality. The assessment and management of refractory patients with mood disorders is a major clinical challenge for mental health providers. Part of the Oxford Psychiatry Library (OPL) series, this pocketbook provides a concise view of the current definitions, assessment and evidence-based management of treatment-resistant mood disorders and reviews novel therapeutic targets for mood disorders, which may enhance the therapeutic armamentarium of clinicians in the near future. The pocketbook serves as a useful guide for mental health practitioners, including psychiatrists, clinical psychologists, trainees, and interested primary care physicians.

Treatment-resistant Depress Successful management of patients with treatment-resistant depression requires a thorough understanding of the biological basis for both the depression and its failure to respond to standard treatments. This book clearly and succinctly summarizes the latest scientific research and its applications in clinical practice. A first step is a clear definition of what constitutes treatment-resistant depression so that clinical trials and other studies are using common criteria, enabling comparison and meta-analysis of their outcomes. The opening chapter reviews definitions and predictors of treatment-resistant depression originating from different fields and discusses their usefulness in clinical practice and clinical research. The next chapter proposes a new definition, adapting terminology from medicine. Biological classification requires identification of genetic risk factors and gene variants have been identified as accounting for 50% of the variance in the clinical outcomes of antidepressant treatments. Chapter 3 describes several genes already associated with treatment-resistant depression and, while further work is needed to translate findings into clinical recommendations, suggests that genetic prediction of treatment resistance could become a widespread clinical reality within a few years. Most patients with treatment-resistant depression will be treated pharmacologically, so three chapters review the latest evidence for pharmacological best practice in switching strategies for antidepressants, the role of antipsychotics and augmentation strategies to complement lithium. There are two major alternatives to pharmacotherapy: neuromodulation and psychotherapy. The brain intervention chapter summarizes clinical research and experience with electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation and magnetic seizure therapy. The final chapter reviews the literature pertaining to the effectiveness of various forms of psychotherapy in patients who have not responded to antidepressant pharmacotherapy, explaining that patients who have not responded to one or two trials of antidepressant medication have a 30%-50% chance of responding to a focused psychotherapy. It proposes indications for psychotherapy in treatment-resistant depression and summarizes general therapeutic principles. Essential reading for all psychiatrists managing patients with this distressing disorder.

As many as 35-40% of patients afflicted with Major Depressive Disorder (MDD) are treatment resistant, a situation that places a massive emotional and financial burden on society and challenges the mental health profession to develop new treatment paradigms and practices. Even the most astute clinicians can be frustrated when treatment options fail to be effective or work for only a brief time, leaving them to wonder what course to pursue next. Treatment Resistant Depression: A Roadmap for Effective Care gives clinicians and their patients what they need most desperately: a sequence of steps that reflect state-of-the-art diagnostic procedures and integrates all evidence-based treatment modalities -- in short, a roadmap to wellness and recovery. Based primarily on the experiences of the authors, all of whom are leading researchers and/or clinicians in Treatment Resistant Depression and affiliated with the University of Michigan Comprehensive Depression Center, the book also draws upon the clinical research advances and treatment innovations of programs around the world. Although the book's step-by-step organization is clear and easy to follow, its coverage, scope, and level of sophistication are anything but simplified. This book Is comprehensive, addressing treatment options, including psychopharmacotherapy, psychotherapy, neuromodulation (ECT, transcranial magnetic stimulation, deep brain stimulation, vagus nerve stimulation), exercise, nutrition, self-management approaches to enhance adherence, behavioral sleep programs, and others Addresses treatment resistant depression across the lifespan, reflecting the diverse demographics of depression, which knows no age, gender, or socioeconomic status Emphasizes the authors' commitment to early intervention and provides techniques for identifying young people who are at risk for developing depression or already expressing symptoms of the disease Recognizes the chronicity of depression, rather than focusing on only the acute stage, and in this way allows for more effective treatment over the patient's lifetime Introduces self-management as playing a critical role in the patient's prognosis, engagement, adherence to clinical steps that help maintain recovery, and self-esteem Promotes the development of new, personalized, and predictive biomarkers to target treatment more effectively. Designed to be useful across disciplines and treatment modalities, the book includes a multitude of tables, graphs, and learning aids that will benefit students, instructors, and clinicians. At the same time, the book promises to be a valuable resource for patients and their families, since Treatment Resistant Depression is both difficult to live with and little understood. No other book offers so much practical guidance, sound research and hope.

Treatment-resistant major depression and bipolar disorder are highly prevalent and disabling conditions associated with substantial morbidity and mortality. Providing a concise view of the current definitions, assessment and evidence-based management of such disorders, this work reviews novel therapeutic targets, which may enhance the future therapeutic armamentarium of clinicians.

Managing Treatment-Resistant Depression: Road to Novel Therapeutics defines TRD for readers, discussing the clinical and epidemiological predictors, economic burden and neurobiological factors. In addition, staging methods for treatment resistance are fully covered in this book, including serotonin specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, other classes of antidepressants, including tricyclic antidepressants and monoamine oxidase inhibitors, augmentation strategies, and newer antidepressant treatments like ketamine and esketamine. In addition, evidence supporting the use of psychotherapies and neuromodulation strategies are also reviewed. Written by top experts in the field, this book is the first of its kind to review all methods of treatment for TRD. Defines Treatment-Resistant Depression and Staging Treatment Intensity Includes Treatment-Resistant Depression options for children, adolescents, geriatrics, during pregnancy, and during post-partum and menopause transitions Discusses the use of Ketamine and Esketamine for treatment-resistant depression

This timely book assesses all aspects of treatment-resistant depression and will be invaluable to professionals.

Treatment-resistant major depression and bipolar disorder are highly prevalent and disabling conditions associated with substantial morbidity and mortality. Providing a concise view of the current definitions, assessment and evidence-based management of such disorders, this work reviews novel therapeutic targets, which may enhance the future therapeutic armamentarium of clinicians.

'This unique book, written by one of the world's leading authorities on depression, focuses on a way of thinking about the complexity and diversity of the mood disorders that is both easy to understand and rings' true. Well-written and thought provoking, it is essential reading for all whose lives are affected by depression.' - Michael Thase, Professor of Psychiatry, University of Pittsburgh 'Everyone with an interest in depression care should read this unique, sensible and innovative approach developed for many years of experience working with depressed people. It is essential reading for sufferers, their carers and professionals.' - Professor Andre Tylee, Institute of Psychiatry, London Most of us get 'the blues' at some point in our lives, and some people find that they just can't shake them. How can you tell when you or someone you know is suffering from depression that needs clinical treatment? How can you find the best treatment for your depression? Dealing with Depression is a brief, user-friendly guide to depression and mood disorders for sufferers, their families, and health professionals who care for them. Professor Parker explains that contrary to popular belief, there are many different types of depression, each benefiting from differing treatments. Since it was first published, Dealing with Depression has been widely used by both general readers and health professionals. This second edition contains new information on bipolar disorders and the influence of personality styles on non-melancholic disorders. It has been updated throughout to reflect recent research.

Primary Care of the Child with a Chronic Condition, fourth edition by Patricia Jackson Allen, RN, MS, PNP, FAAN; and Judith A. Vessey, RN, PhD, MBA, DPNP, FAAN, supplies the necessary knowledge to provide comprehensive primary care to children with chronic conditions and their families. Book jacket.