Researchers at the University of Bristol are looking for volunteers to help answer this question by taking part in an important new study.

Severe or recurrent depression affects three to five per cent of the population.  Between 10 and 30 per cent of these people do not respond to current treatments and there are few new treatments in development.  People with treatment resistant depression (TRD) are often profoundly disabled and, in the UK, their needs are seldom met as NHS psychiatric services are often overstretched by providing a service to people with psychosis.

The Bristol researchers, led by Dr Andrea Malizia, are looking to recruit patients who have failed to respond to two antidepressant medications.  They want to see if a short course (three days) of hydrocortisone can improve depression in people who have TRD.

Evidence from UK and US studies suggests that a short course of steroids, such as hydrocortisone, may be sufficient to trigger a beneficial response in people who have TRD who are on 'standard' antidepressant treatment.  If this were to be confirmed, it would be a significant advance as it may enable a restoration of response to conventional treatments in these individuals.  A further advantage is that such an intervention is inexpensive, relatively simple and could be carried out in outpatient or even appropriate primary care settings.

The researchers are looking for patients with depression who have failed to respond to two antidepressant medications and who would like to be assessed for entry into the study. 

Dr Malizia has a long-standing clinical and research interest in treatment resistant depression and leads a specialist outpatient service at the Bristol Royal Infirmary.  Other members of the research team include psychiatrists and sleep specialists.

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According to Ms Hocking the figures reflect the general poor physical health care provided to people regarded all too often as solely ???mental health patients?? and SANE is calling on government agencies at all levels to improve opportunities for those affected to improve their relationships with others and improve their capacity for recovery.

Church groups, youth organisations and mental health centres are urged to be aware of the issue and to organise more social functions in order to ensure people with a mental illness are included in their communities and have opportunities to meet and socialise with others.

The study recommends the promotion of social inclusion by means of recovery-focused rehabilitation programs, to improve confidence, communication and social skills; that support is offered to develop relationships and education and training provided into how to discuss mental illness and its effect on emotional, physical and sexual intimacy.

Also recommended is improved sex education as mental illness often starts in late teens, disrupting the of learning of life skills and education and for more practical education about sexuality and related issues.

The study suggests health professionals need incentives to provide sexual health checks, regular breast screening, pap smears, STD testing, prostate checks and routine tests for those suffering with a mental illness.