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Homburg/Berlin – The treatment of chronic and treatment-refractory depressive syndromes is a particular challenge for those affected and their relatives, the practitioners and the payers. Trauma-related disorders are a factor that can maintain depressive syndromes. Ulrike Schmidt (Homburg/Saar) reported this today at the annual congress of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DPPPN) in Berlin (lecture and presentation ID EP-02-01).

“A depressive syndrome is called chronic if it lasts longer than 2 years and a depressive episode is considered refractory to treatment if 2 adequate antidepressant treatment attempts have not resulted in significant improvement,” says Schmidt, deputy director of the psychiatric and psychotherapeutic department at Saarland University Hospital .

There is evidence in the literature that trauma and trauma-related disorders such as post-traumatic stress disorder (PTSD) and in particular complex post-traumatic stress disorder (kPTSD) represent disease-maintaining factors in some people with chronic or treatment-refractory depressive syndromes.

Schmidt reported that a systematic review she conducted for the lecture showed that trauma and trauma-related disorders are highly prevalent in populations with treatment-refractory and chronic depression and that PTSD present at the start of antidepressant therapy significantly influences the outcome of therapy.

In a cohort of PTSD patients recruited by the speaker, depressive syndromes improved significantly through trauma-focused psychotherapy, although pharmacotherapy was not changed during this treatment period. 69% of all patients with PTSD and treatment-refractory or chronic depression stated that they had never been asked about traumatic experiences or symptoms of PTSD in previous treatments, although almost 80% of them had already undergone psychotherapeutic treatment at least once had found.

“From the results of these analyses, it can be concluded that a structured diagnosis and treatment of trauma-related disorders could significantly improve the treatment situation of a subpopulation of people with treatment-refractory or chronic depression,” was Schmidt’s conclusion. © hil/aerzteblatt.de