A Multidimensional Perspective of Treatment-Resistant Depression: The Staging Model

Various clinical guidelines and studies propose definitions of treatment-resistant depression (TRD), yet numerous conceptual and practical challenges remain. TRD has been historically defined as a dichotomous concept; this definition has been criticized for not reflecting clinical reality. The dichotomous definition aids in identifying and differentiating responders from those with less severe forms of treatment resistance. The continuous approach utilizes a staging model, proposed as a more refined transitional diagnostic approach. An operational definition for TRD would guide clinicians to select treatment options better and may ultimately help prevent prolonged depressive illness.