ABSTRACT
This chapter investigates a special group of patients: patients with so-called difficult to treat depression (DTD). The other aim is to draw attention to the perspective of patients with refractory depression, some factors that have an impact on the maintenance of the depressive state and on the immense amount of suffering of these patients. There are well-established treatments available that can be applied in cases of acute depressive episodes, of relapse prevention, and in cases of early interventions: psychopharmacological treatments and psychotherapeutic treatments. Both groups of treatments have several specific foci, heterogeneous approaches, and diverging scientific evidence. Depression is one of the most frequent psychiatric diseases of adults. Clinical case studies can be found as well as systematic case studies. Most of the empirical studies published draw attention to the complexity and variety of depressive diseases and underline the necessity for multidimensional forms of treatment.
