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Research and Projects

Treatment Resistant Depression Delphi Project

Theme: CLAHRC - Mental Health & Dementia
Status: Live

This review is being led by the Evidence Synthesis Team.


This work arose following a consensus meeting to establish PenCLAHRC priorities in mental health. 
Despite significant advances in the treatment of depression, somewhere between 10 - 20% of patients continue to experience long-term poor outcomes. To date, the vast majority of research addressing this issue has focussed on how to help people for whom antidepressant medication (ADM) does not relieve depression. However, there is not sufficient consensus on how many ADM should have failed, and there is still uncertainty amongst clinicians and researchers as to whether psychosocial and/or qualitative factors should be taken into account.  

Project aims

The aim of this study is to assess expert opinion and consensus on the use of the term TRD with regard to ADM, psychotherapy and qualitative factors. We also intend to gather leading opinion on the appropriateness of the term TRD, and also on any other terms which may be preferred by certain experts. Given these aims, the Delphi was considered the most appropriate method because its iterative processes and anonymous feedback loops can help identify ‘central tendency’ among a group and measure the ‘level of agreement’ around it. By polling experts individually online, it also allows geographically dispersed people to be consulted in a short space of time, and protects against factors that negatively influence face-to-face group decision making.

Further information

For more information, view the protocol.