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The Problem of Treatment-Resistant Psychiatric Disorders 

The Problem of Treatment-Resistant Psychiatric Disorders
Chapter:
The Problem of Treatment-Resistant Psychiatric Disorders
Author(s):

Patricio Riva Posse

and Charles B. Nemeroff

DOI:
10.1093/med/9780199739981.003.0001
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date: 22 November 2017

Psychiatric disorders are among the leading causes of morbidity and mortality worldwide. Despite considerable advances in the understanding of the pathophysiology and the availability of effective therapies that include pharmacological and nonpharmacological approaches (somatic and psychotherapeutic), there are still a sizeable number of patients that do not respond adequately to treatment, either in the magnitude of the response or the persistence of the response. Treatment resistance is variably defined in different psychiatric disorders, and there are multiple factors that contribute to it, among them genetic, environmental, medical, and psychiatric comorbidities. The consequences of treatment resistance are devastating for the patients, including poor quality of life, chronic disability, increased risk for medical illness, substance and alcohol abuse, and suicide, as well as to families and societies who deal with the increasing psychological and financial burden. Careful diagnostic reevaluation of patients who appear treatment resistant must be conducted and the most effective evidence-based strategies applied to their care.

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