A Southeast Asia Consensus on the Definition and Management of Treatment-Resistant Depression

Phern Chern Tor,1 Nurmiati Amir,2 Johnson Fam,3 Roger Ho,3 Pichai Ittasakul,4 Margarita M Maramis,5 Benita Ponio,6 Dharmawan Ardi Purnama,7 Wanida Rattanasumawong,8 Elizabeth Rondain,9 Ahmad Hatim Bin Sulaiman,10 Kannokarn Wiroteurairuang,11 Kok Yoon Chee12 1Department of Mood and Anxiety, Institute of Mental Health, Singapore; 2Department of Psychiatry, Cipto Mangunkusumo Hospital, Jakarta Pusat, Indonesia; 3Department of Psychological Medicine, National University Hospital, Singapore; 4Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 5Department of Psychiatry, Dr. Soetomo General Academic Hospital-Faculty of Medicine, Airlangga University, Surabaya, Indonesia; 6Department of Psychiatry, Metro Psych Facility, Manila, Philippines; 7Dr Soeharto Heerdjan Jakarta Mental Hospital, Jakarta, Indonesia; 8Department of Psychiatry, Phramongkutklao Hospital, Bangkok, Thailand; 9Department of Psychiatry, Makati Medical Center, Makati City, Philippines; 10Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 11Prasrimahabodhi Psychiatric Hospital, Ubon Ratchathani, Thailand; 12Department of Psychiatry, Hospital Kuala Lumpur, Kuala Lumpur, MalaysiaCorrespondence: Ahmad Hatim Bin Sulaiman, Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603, Malaysia, Email hatim@um.edu.myIntroduction: Despite the abundance of literature on treatment-resistant depression (TRD), there is no universally accepted definition of TRD and available treatment pathways for the management of TRD vary across the Southeast Asia (SEA) region, highlighting the need for a uniform definition and treatment principles to optimize the management TRD in SEA.Methods: Following a thematic literature review and pre-meeting survey, a SEA expert panel comprising 13 psychiatrists with clinical experience in managing patients with TRD convened and utilized the RAND/U