Depression: Managing Resistance and Partial Response to Treatment.

Treatment-resistant depression is defined as absence of remission despite trials of two or more antidepressant medications and can occur in up to 31% of patients with major depressive disorder. Partial response to treatment is defined as less than 50% reduction in depression-rating scores. Before diagnosing treatment-resistant depression or partial response to treatment, adherence to adequate doses and duration of medications should be confirmed. Management strategies include adding psychotherapy, switching antidepressant medication class, or augmenting with additional medications. Current guidelines recommend augmentation with a second-generation antidepressant, an atypical antipsychotic, tricyclic antidepressants, lithium, or a triiodothyronine medication as pharmacologic options. Ketamine and esketamine can also be used as augmentation for treatment-resistant depression and may help reduce suicidal ideation. Electroconvulsive therapy and repetitive transcranial magnetic stimulation may be effective. Pharmacogenetic testing has limited evidence and is not recommended. Nonpharmacologic therapies include psychotherapy, exercise, and focused dietary changes.

Mental Health Concerns for College Students: Self-Harm, Suicidal Ideation, and Substance Use Disorders.

Mental health disorders in college students are an increasing concern within the United States. Many factors lead to the increase in disorders during this transition period but most are centered on the needed adjustments into adult life and lack of foundation to make these changes. Socioeconomic and racial demographics play a role in the risks of developing and seeking treatment of these issues. Mental health first aid may become the first-line modality to finding and treating mental health disorders in these students.