The burden associated with, and management of, difficult-to-treat depression in patients under specialist psychiatric care in the United Kingdom

The burden associated with, and management of, difficult-to-treat depression in patients under specialist psychiatric care in the United Kingdom


Tiago Costa, Bayar Menzat, Tomas Engelthaler, Benjamin Fell, Tarso Franarin, Gloria Roque, Yiran Wei, Xinyue Zhang, R Hamish McAllister-Williams

Northern Centre for Mood Disorders, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
Akrivia Health, Oxford Centre for Innovation, Oxford, UK
Etcembly Ltd, Magdalen Centre, Oxford, UK

Major depressive disorder (MDD) is common and often has sub-optimal response to treatment. Difficult-to-treat depression (DTD) is a new concept that describes ‘depression that continues to cause significant burden despite usual treatment efforts’.

To identify patients with likely DTD in UK secondary care and examine demographic, disease and treatment data as compared with ‘non-DTD’ MDD patients.

Anonymised electronic health records (EHRs) of five specialist mental health National Health Service (NHS) Trusts in the United Kingdom were analysed using a natural language processing model. Data on disease characteristics, comorbidities and treatment histories were extracted from structured fields and using natural language algorithms from unstructured fields. Patients with MDD aged ⩾18 years were included in the analysis; those with presumed DTD were identified on the basis of MDD history (duration and recurrence) and number of treatments prescribed.

1. Costa T, Menzat B, Engelthaler T, et al. The burden associated with, and management of, difficult-to-treat depression in patients under specialist psychiatric care in the United Kingdom. Journal of Psychopharmacology.
May 2022.