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Treatment-resistant depression (TRD) has been estimated to affect up to 30% of patients, or 60% if the TRD definition includes the absence of remission (although prevalence depends on number of treatments tried). For 8 to 84 months, researchers in the U.K. followed 118 of 150 patients discharged from a specialized unit for TRD who were extremely ill (mean of 6 treatments for current episode; history of electroconvulsive therapy, 65%; suicide-attempt history, 60%). Depression was unipolar in 77 patients, bipolar in 27, and secondary (to other psychiatric disorders) in 14.
After a mean of 39 months, 60% met remission criteria (with 48% sustaining remission for 6 months); 20% had subsyndromal depression and 20% full depression. Lesser likelihoo…