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CNN
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Relatives of treatment-resistant individuals depression People are nine times more likely to develop depression that doesn’t respond to conventional treatments, a new study has found.
People with treatment-resistant depression, also known as TRD, require standard treatments such as psychiatric therapy and psychotherapy. antidepressants Even if it doesn’t work at all, it might not work very well.A person can diagnosed TRDs are taken when symptoms are not relieved after taking two different antidepressants.
The study is the first and largest to use country-wide data to confirm the association between the genetic transmission of TRD among families and other major psychiatric disorders, said lead author National Yangming said Dr. Chen Ta Li, professor of medicine at Jiaotong University. East University in Taipei, Taiwan.
Family members of TRD patients are also much more likely to develop other types of mental illness, such as anxiety, bipolar disorder, obsessive-compulsive disorder, major depressive disorder, attention-deficit hyperactivity disorder, and to commit suicide. You are also more likely to die. According to research.
“This is the most convincing evidence to date that treatment-resistant depression tends to run in families,” said Andrew Mackintosh, professor of psychiatry at the Center for Clinical Neuroscience at the University of Edinburgh in Scotland. the doctor said. He was not involved in the study.
McIntosh said in an email that the findings suggest a genetic basis, but that families may share life events, socioeconomic disadvantage or other unidentified risk factors. .
“This is particularly interesting because this subgroup may have different genetic and other causes of depression that are not adequately addressed by current antidepressants,” he said.
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Experts say being aware that treatment-resistant depression runs in families can help with early treatment options.
The study was published Wednesday in the journal JAMA Psychiatryanalyzed national health insurance data for the entire Taiwanese population over a 15-year period, including inpatient and outpatient medical records and prescription information.
Over 500,000 Taiwanese were diagnosed with major depressive disorder during this period. Of those, more than 21,000 were diagnosed with treatment-resistant depression. This is defined as having received at least three antidepressant medications over a 2-year period without success. This is one more time than is usually needed for diagnosis.
First-degree relatives (including parents, siblings, and children) of people with TRD are nine times more likely to develop treatment-resistant depression and at increased risk of all-cause death and death by suicide compared to relatives of people without TRD. was high. Research has revealed this.
“The results of our study suggest that in depressed patients with a family history of TRD, other treatment options may be considered early if initial antidepressant treatment is ineffective.” ,” Dr. Lee said.
Such alternative treatments may include the addition of lithium or other atypical antipsychotics, low-dose ketamine, also known as esketamine, or repeated transcranial therapy, a type of shock therapy that does not require sedation and has no cognitive adverse effects. May include the use of magnetic stimulation. said Mr. Lee.
“For too long we have been content to focus on the study of people of European descent in Europe and North America (and) we have too easily assumed that Europeans are representative of the planet. “It often ends up being a problem,” McIntosh said. “So this is a really welcome piece of research that goes some way to addressing the underrepresentation of Asians in research.”
