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Yıl:2011; Cilt: 1; Sayı: 3>> Özet
Psikiyatride Güncel; 2011;1(3):189-191
Tedaviye Dirençli Depresyonda Temel Kavramlar
Ö Aydemir
Celal Bayar Üniv. Tıp Fak. Psikiyatri ABD, Manisa
Depresyon tedavisini planlarken hedeflerin belirlenmesi gereklidir. Hedefler ne kadar iyi tanımlanırsa, tedavinin izlenmesi ve denetlenmesi
de o düzeyde olanaklı olur. Bu amaçla klinik psikiyatrik ölçekler kullanılmaktadır. Yanıt başlangıç puanına göre ölçek puanında
en az %50 azalma sağlanması olarak tanımlanmaktadır. Uygulanan tedaviye %25-50 arasında yanıt vermesi yetersiz yanıt, yanıtın
%25'i n altında kalması olarak tedaviye yanıtsız olarak değerlendirilmektedir. Hastanın düzelmesi ise hastanın belirtilerinin hemen
tama yakın oranda ortadan kalkmasıdır ve düzelme ölçütü olarak kullanılan ölçeklerde belirlenen kesme puanının altına düşmesi
hedeflenmektedir. Hamilton Depresyonu Derecelendirme Ölçeği için düzelme 7 puanın, Montgomery Asberg Depresyonu Derecelendirme
Ölçeği için ise 10 puanın altına düşmesi düzelme olarak hesaplanmıştır. Tedavide istenen sonucun elde edilememesi sonucu
inatçı, dirençli, yanıtsız ve tedavi edilemeyen depresyon gibi kavramlar ileri sürülmektedir. Tedaviye dirençli depresyonda çeşitli
evreleme çalışmaları yapılmaktadır.
Basic concepts in treatment resistant depression

In the treatment plan of depression the goals should be determined. The better the goals are described, the more possible the treatment
is followed up and monitored. For this purpose clinical psychiatric scales are in use. Response is defined as 50% reduction in the index
scale score. Inadequate response to the treatment is defined as 25-50% reduction and no response to treatment is described when the
reduction is below 25%. %. Remission is defined as the improvement of nearly all symptoms and during the monitorization of remission
it is targeted of the scales to drop below the cutoff score. It is calculated as the reduction of Hamilton Depression Rating Scale
below 7 and the reduction of Montgomery Asberg Scale below 10. When the expected treatment goals are not achieved in depression,
the concepts such as persistent, resistant, refractory and intractable depression are described. In treatment resistant depression, studies
for staging are performed.

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