{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:23:41Z","timestamp":1760145821234,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T00:00:00Z","timestamp":1724457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Pharmacological resistance in severe recurrent mood and anxiety disorders remains a significant challenge in modern biological psychiatry. This case report investigates the intricate decision-making process employed by physicians when managing patients resistant to conventional pharmacotherapy. Methods: Informed consent was obtained from the patient. Following this, the case report was developed using the CARE checklist (2013) to ensure a comprehensive and systematic documentation of the treatment process and outcomes. Results: The patient\u2019s treatment history highlights the complex nature of pharmacological resistance and the impact of minor medication adjustments versus established clinical practices. A crucial aspect of this case was the patient\u2013physician relationship, particularly addressing the patient\u2019s past grievances towards physicians, which played a significant role in the treatment process. Despite efforts to improve the physician\u2019s confidence and approach, challenges such as lack of continuity and a fragile therapeutic relationship contributed to treatment failure. Conclusions: This case underscores the importance of psychodynamic models in overcoming pharmacologic challenges. A deeper understanding of the patient\u2013physician dynamics and addressing underlying emotional factors can enhance treatment efficacy and patient outcomes, providing valuable lessons for managing complex cases of treatment resistance.<\/jats:p>","DOI":"10.3390\/jpm14090897","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T05:16:24Z","timestamp":1724649384000},"page":"897","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Psychodynamic Insights into Treatment-Resistant Pharmacotherapy: A Case Study Exploring Patient\u2013Physician Dynamics and Adherence to Evidence-Based Practices"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9820-6025","authenticated-orcid":false,"given":"Alexander","family":"Baur","sequence":"first","affiliation":[{"name":"Orthopaedics Department, Liberty University College of Osteopathic Medicine, Lynchburg, VA 24502, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie","family":"Kryzanowski","sequence":"additional","affiliation":[{"name":"Virginia Beach Psychiatric Center, Virginia Beach, VA 23454, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,24]]},"reference":[{"key":"ref_1","first-page":"23","article-title":"When at first you don\u2019t succeed: Sequential strategies for antidepressant nonresponders","volume":"58","author":"Thase","year":"1977","journal-title":"J. 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