치료저항성 우울증에서 정신역동정신약물학적 접근

Abstract

Depression remains a major public health challenge, particularly when it becomes treatment-resistant. The development and recovery of depression involve complex interactions among biopsychosocial factors. While the treatment of depression is comprehensive, treatment-resistant depression (TRD) often leans heavily on biological interventions. This review advocates for an integrated approach combining pharmacotherapy and psychotherapy, introducing psychodynamic psychopharmacology as a promising alternative. This strategy aims to enhance treatment outcomes by addressing treatment resistance-related psychodynamic factors and fostering a therapeutic alliance. Notably, the framework categorizing treatment resistance into two types and outlining specific management principles holds practical applicability. Investigating this integrated approach may not only deepen our understanding of TRD but also broaden therapeutic options for clinicians.