Long-Term Outcome of Treatment-Resistant Depression in Older Adults

Seventeen elderly patients with treatment-resistant depression were reassessed 15 months and 4 years after treatment with an antidepressant agent or ECT. At 15 months 47% (seven of I 5) were clinically improved, and at the 4-year follow-up 71 % (1 0 of I 4) were improved. These results indicate that treatment-resistant depression may improve over time because of either the natural course of the illness or persistent treatment efforts. (Am J Psychiatry 1993; 150:1539-1540) W e previously described the 6-month and 4-year outcomes of older patients who participated in a naturalistic treatment study of major depression (1, 2). While the outcomes were generally favorable, we nevertheless identified a subgroup of patients whose depression was initially resistant to treatment. In this paper we report the long-term outcome of this subgroup of patients.