Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults
Knowledge Gaps and Future Research Needs
Information about health-related outcomes that concern quality of life or levels of functional impairment is substantially missing from current studies. Few studies compare nonpharmacologic interventions with each other or with pharmacologic interventions. Moreover, the comparative effectiveness of combined treatment interventions has not been evaluated. Nearly no direct evidence exists on how the comparative effectiveness of nonpharmacologic treatments might differ as a function of symptom subtypes or for subgroups defined by sociodemographic characteristics (e.g., age) or by coexisting medical conditions (e.g., depression following a stroke or a myocardial infarction; perinatal depression). The following shortcomings of evaluated studies may limit the applicability or generalizability of some findings:
- Inconsistent definitions of TRD
- Inconsistent reporting of measured outcomes
- Short followup periods
- Limited, short-term, variable, and inconsistent adverse event reporting
- Gaynes BN, Lux L, Lloyd S, et al. Nonpharmacologic Interventions for Treatment-Resistant Depression in Adults. Comparative Effectiveness Review No. 33 (Prepared by RTI International–University of North Carolina (RTI-UNC) Evidence-based Practice Center under Contract No. 290-02-0016-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-EHC056-EF. Available at: http://www.effectivehealthcare.ahrq.gov/trd.cfm.
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