Current Nosology of Treatment Resistant Depression: A Controversy Resistant to Revision

Michele Fornaro1, *, Patricia Giosuè2
1 Department of Neuroscience, Section of Psychiatry, University of Genova, Genoa, Italy
2 National Health Trust, Department of Mental Health, Atri, Teramo, Italy

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© Fornaro and Giosuè; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neuroscience, Section of Psychiatry, Largo Rosanna Benzi n.16, Genova, ZIP 16100, Italy; Tel/Fax: +39 3474140003; E-mail:


Treatment-Resistant Depression (TRD) represents a source of ongoing clinical and nosological controversy and confusion. While no univocal consensus on its definition and specific correlation with major mood disorders has been reached to date, a progressively greater number of evidences tend to suggest a revision of current clinical nosology. Since a better assessment of TRD should be considered mandatory in order to achieve the most appropriate clinical management, this narrative review aims to briefly present current most accepted definitions of the phenomenon, speculating on its putative bipolar diathesis for some of the cases originally assessed as unipolar depression.

Keywords: Treatment Resistant Depression, Bipolar Disorder, Controversy.