
Rethink “treatment-resistant depression” by adopting difficult-to-treat depression, verifying adequate trials, and stratifying drivers like trauma and inflammation to improve outcomes.

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.

Rethink “treatment-resistant depression” by adopting difficult-to-treat depression, verifying adequate trials, and stratifying drivers like trauma and inflammation to improve outcomes.

Find the references for October cover story, "Moving Away From Treatment-Resistant Depression and Toward Difficult-to-Treat Depression," by Walter Paganin, MD, PhD, here.

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.