Prevalence of Treatment Resistant Depression: TRAL study sub analysis in a Mexican sample

Abstract

Introduction: Epidemiology and burden of disease in LatAm is often scarce in psychiatric disorders. This is particularly relevant in Treatment-Resistant Depression (TRD), a burdensome condition in a significant proportion of Major depressive disorder (MDD) patients. The Treatment Resistant Depression in America Latina (TRAL) study set out to characterize the epidemiology and burden of TRD in MDD patients. This manuscript presents this characterization for the Mexico subset based on data from the TRAL study. Methods: A sample of 697 adult patients clinically diagnosed with MDD were recruited from 14 Mexican sites. Patients with relevant psychiatric comorbidities or enrolled in a clinical trial were excluded. Outcomes were mainly patient reported outcomes and assessment scales. Results: Prevalence of TRD in Mexico was 20.7%. Current suicidality is high in TRD patients (20.8%), as well as suicide behavior disorder (12.5%). SSRIs and SNRIs were the most common medications. Results from EQ-5D, SDS and WPAI show significant limitations for TRD patients in their everyday life. Discussion: Current results are aligned with available literature on treatment and prevalence of suicidality and suicide behavior disorder. The prevalence of TRD in MDD patients is high and presents a management challenge.  Conclusions: The burden of TRD in Mexico is significant, although less severe than in other LatAm countries. Public health policies should improve diagnosis and availability of novel more efficacious therapies.