Poor Treatment Adherence, Delay Key Challenges to Recovery From Depression

Depression is a leading cause of disability worldwide, with over 300 million people of all ages suffering from the debilitating condition globally, according to the World Health Organization (WHO). Even in America, a large number of patients suffering from depression throng primary care settings of medical care.

However, some major hurdles at this level, like the lack of proper logistics and expertise, pose considerable challenges in accessing the right treatment. In fact, many scientists have raised a red flag due to the dearth of effective solutions at the primary care level. Due to the dynamic nature of depression and the variance and anomalies seen in the outcomes of its treatment, medical practitioners and experts have outlined various programs according to the different aspects of recovery and specific requirements of each patient.

Furthermore, during the process of depression rehabilitation, external factors that are generally difficult to observe under medical supervision can further offset the treatment outcomes. These factors may include the co-occurrence of depression and other diseases, poor adherence of medical regimens, personal hardships, etc., which significantly contribute to the non-remission of depression due to delay and inaccurate interventions.

Among individuals with major depressive disorder (MDD), it is often seen that depressive symptoms do not abate even after one or more rounds of treatment for depression. Moreover, some patients who experience remission in their depressive symptoms have to confront the lingering uncertainties about how long the period of remittance will last due to the hurdles posed by external factors.

Challenges of treatment resistance

A study conducted by the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trials delves into the prevalence of remission and non-remission among patients challenged with depression. The findings of the study published in the journal Depression and Anxiety highlight the importance of integrated care for addressing both physical and mental health needs of the patients to improve treatment adherence. The researchers also found that poor treatment and poor physical health might increase the common risk factors, such as failure to remit, delayed or partial remission, etc.

STAR*D, a collaborative study funded by the National Institute of Mental Health (NIMH), compared the effectiveness of several medications or their combinations in patients suffering from MDD. As a multisite, multi-step, prospective and randomized trial, this study played a pivotal role in defining the gaps and solutions for the treatment of depression.

The study entailed 3,606 patients aged 18 to 75 years who could move to another level of treatment due to the failure of previous treatment in completely diminishing their depressive symptoms. Using the method of statistical modeling, Ramin Mojtabai, M.D., Ph.D., M.P.H., of Johns Hopkins University tried to classify patients whose depressive symptoms remitted and those whose symptoms did not remit during the trial. Based on the results, researcher also tried to identify the risk factors for each patient.

Over the course of the 12-month trial, the study found some other results as follows:

· Remission varied substantially among remitters and 14.7 percent of the participants were estimated to be non-remitters.

· The failure to remit was associated with the lack of college education, current unemployment and long duration of the depressive episode.

· Delayed remission was significantly associated with seeking care at a specialty treatment setting, poorer mental health functioning assessed by the 12-item Short-Form Health Survey and impairment in role functioning assessed by the Work and Social Adjustment Scale.

“Treatment resistance is often clinically defined by non-remission after two adequate antidepressant medication treatment trials. Yet, treatment-resistant cases are likely heterogeneous of those who would remit in response to treatment more slowly and those who would not remit and would have a chronic course,” wrote Mojtabai.

In addition, the study highlights the need for a new medication treatment for patients who haven’t responded to prior interventions. Lastly, the subtle nuances that distinguish non-remission from a longer period of remission observed in remitters further advocate the need for treatment planning and accounting for unforeseeable treatment challenges.

Depression is an illness, not a weakness

Depression is a highly treatable mental disorder under favorable circumstances. Although variability in treatment outcomes is a cause for concern, it is important to understand that a medical intervention is only a part of the treatment. The major challenges confronting depression treatment include adherence to medication regimens, development of adaptive coping mechanisms, etc. that can reduce the adverse impact of daily stressors.

If you or your loved one is battling depressive symptoms, contact the Texas Depression Treatment Help. Call at our 24/7 helpline number (866) 827–0282 to know more about the finest depression treatment centers in Texas that specialize in delivering evidence-based intervention plans.

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