
Much of what we call "treatment-resistant" depression may be mismatched, not resistant. A psychiatrist makes the case for trading the failed-drug tally for a difficult-to-treat framework clinicians can act on Monday morning.

Dr Paganin is a psychiatrist and psychotherapist in the public mental health service and holds a PhD in neuroscience at the University of Rome Tor Vergata, Rome, Italy; he also collaborates with Studio Psicologia Signorini, Guidonia, Italy. His research focuses on difficult-to-treat depression and the neurobiology of psychiatric disorders, with particular attention to the role of childhood trauma, and he works with multifamily and interfamilial therapy approaches.

Much of what we call "treatment-resistant" depression may be mismatched, not resistant. A psychiatrist makes the case for trading the failed-drug tally for a difficult-to-treat framework clinicians can act on Monday morning.