Table 1 Summarization of the results of the 17 statements
Consent | Agreement | ||
|---|---|---|---|
1. | In my opinion environmental and personological factors are among the main factors responsible for the non-response to treatment of almost all patients with TRD | + | ± |
2. | In my clinical practice I also consider as treatment resistant a patient with incomplete improvement of symptoms (partial response) after an adequate period of treatment | − | ± |
3. | In clinical practice I usually use scales/questionnaires for the diagnostic classification and/or evaluation of the clinical course of the patient with depression | − | ± |
4. | In my opinion a shared strategy is being pursued in Italy (based on guidelines, evidence-based treatments, diagnostic-therapeutic pathways) for the management of patients with TRD | + | ± |
5. | Based on my clinical experience, I believe that after the second treatment failure there is a clear reduction in remission chances | + | ± |
6. | When I treat a depressed patient, if after 3–4 weeks there is no response, I decide to change the antidepressant therapy | − | ± |
7. | When treating a depressed patient who has failed to respond to two antidepressants, I believe the best option is to combine an antipsychotic, such as quetiapine | − | ± |
8. | When treating a depressed patient who has failed to respond to two antidepressants, I do tend to add lithium first | + | + |
9. | In treating a depressed patient who has failed to respond to two antidepressants I do tend to associate psychotherapy first | + | ± |
10. | When treating a depressed patient who has failed to respond to two antidepressants, I believe the best option is to combine esketamine (if currently available or when available in my centre) | + | + |
11. | I am satisfied with the efficacy of lithium and/or antipsychotics as augmentation therapies for patients with TRD | + | + |
12. | I use (or I will use) esketamine nasal spray only after non-response to the available augmentation/increase strategies | − | ± |
13. | After obtaining a satisfactory response to treatment in a patient with TRD, long-term maintenance of therapy is essential | + | + |
14. | In my opinion most patients with TRD can be treated with esketamine nasal spray in a community outpatient setting, without difficulties | + | + |
15. | Educational support for patients helps to make the best use of the therapeutic opportunity offered by esketamine nasal spray | + | + |
16. | In my daily reality, I have adequate and sufficient resources (staff, logistics, facilities, etc.) to provide patients with TRD with the best possible care | + | + |
17. | In my opinion there are aspects of professional responsibility that the clinician must take into consideration in order to prefer, when possible, drugs with approved clinical indications for patients with TRD | + | + |