Major challenges in youth psychopathology: treatment-resistant depression. A narrative review.

Autor:	Menculini G; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Cinesi G; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Scopetta F; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Cardelli M; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Caramanico G; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Balducci PM; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.; Community Mental Health Center 'CSM Terni', Department of Psychiatry, Local Health Unit USL Umbria 2, Terni, Italy., De Giorgi F; Division of Psychiatry, Clinical Psychology and Rehabilitation, General Hospital of Perugia, Perugia, Italy., Moretti P; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy., Tortorella A; Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in psychiatry [Front Psychiatry] 2024 Jul 11; Vol. 15, pp. 1417977. Date of Electronic Publication: 2024 Jul 11 (Print Publication: 2024).
DOI:	10.3389/fpsyt.2024.1417977
Abstrakt:	Major depressive disorder (MDD) represents a major health issue in adolescents and young adults, leading to high levels of disability and profoundly impacting overall functioning. The clinical presentation of MDD in this vulnerable age group may slightly differ from what can be observed in adult populations, and psychopharmacological strategies do not always lead to optimal response. Resistance to antidepressant treatment has a prevalence estimated around 40% in youths suffering from MDD and is associated with higher comorbidity rates and suicidality. Several factors, encompassing biological, environmental, and clinical features, may contribute to the emergence of treatment-resistant depression (TRD) in adolescents and young adults. Furthermore, TRD may underpin the presence of an unrecognized bipolar diathesis, increasing the overall complexity of the clinical picture and posing major differential diagnosis challenges in the clinical practice. After summarizing current evidence on epidemiological and clinical correlates of TRD in adolescents and young adults, the present review also provides an overview of possible treatment strategies, including novel fast-acting antidepressants. Despite these pharmacological agents are promising in this population, their usage is expected to rely on risk-benefit ratio and to be considered in the context of integrated models of care. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Menculini, Cinesi, Scopetta, Cardelli, Caramanico, Balducci, De Giorgi, Moretti and Tortorella.)
Databáze:	MEDLINE
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