Transtorno depressivo maior: diferentes possibilidades para pacientes resistentes ao tratamento

Major depressive disorder is currently considered a public health issue due to the high prevalence rate in the general population. Often, this disorder is neither diagnosed nor treated, causing relevant impacts in all spheres of the individual's life. In order to analyze what has been discussed on the subject, a narrative review was carried out about the different resources involved in the treatment of major depressive disorder for resistant patients. The results found indicated that depression is easily confused with other pathologies precisely because of the physical symptoms presented by the patients. The stigma surrounding mental health is also an aggravating factor for treatment. Through this review, it was possible to verify that although there are promising and efficient medical treatments, such as electroconvulsive therapy and transcranial magnetic stimulation, they are not accessible to the entire population, since there is no investment for those procedures in the Unified Health System. Cognitive-behavioral psychotherapy combined with the use of drugs stands out in relation to other types of available resources, mainly in aspects that involve quality of life and functionality.Major depressive disorder is currently considered a public health issue due to the high prevalence rate in the general population. Often, this disorder is neither diagnosed nor treated, causing relevant impacts in all spheres of the individual's life. In order to analyze what has been discussed on the subject, a narrative review was carried out about the different resources involved in the treatment of major depressive disorder for resistant patients. The results found indicated that depression is easily confused with other pathologies precisely because of the physical symptoms presented by the patients. The stigma surrounding mental health is also an aggravating factor for treatment. Through this review, it was possible to verify that although there are promising and efficient medical treatments, such as electroconvulsive therapy and transcranial magnetic stimulation, they are not accessible to the entire population, since there is no investment for those procedures in the Unified Health System. Cognitive-behavioral psychotherapy combined with the use of drugs stands out in relation to other types of available resources, mainly in aspects that involve quality of life and functionality.O transtorno depressivo maior é considerado atualmente uma questão de saúde pública devido à alta taxa de prevalência na população em geral. Com frequência, esse transtorno não é diagnosticado nem tratado, gerando impactos relevantes em todas as esferas da vida do indivíduo. Objetivando analisar o que se tem discutido sobre o assunto realizou-se uma revisão narrativa acerca dos diferentes recursos envolvidos no tratamento do transtorno depressivo maior para pacientes resistentes. Os resultados encontrados indicaram que a depressão é facilmente confundida com outras patologias justamente pelos sintomas físicos que os pacientes apresentam. O estigma que envolve a saúde mental também é um fator agravante ao tratamento. Por meio dessa revisão foi possível constatar que embora existam tratamentos médicos promissores e eficientes, como a eletroconvulsoterapia e a estimulação magnética transcraniana, eles não são acessíveis à toda população, uma vez que para esses procedimentos não há investimento no Sistema Único de Saúde. Já a psicoterapia cognitivo-comportamental combinada ao uso de fármacos sobressai-se em relação a outros tipos de recursos disponíveis, principalmente nos aspectos que envolvem qualidade de vida e funcionalidade