The role of psychiatric nurses in nutritional care for treatment-resistant depression: a relapse-prevention perspective

Treatment-resistant depression (TRD) is associated with persistent symptoms, impaired functioning, physical comorbidity and a high risk of recurrence, making continuation and maintenance care particularly important. Nutrition may influence several modifiable aspects of recovery, including cardiometabolic health, daily functioning, self-care and treatment adherence, although evidence for a direct effect on depressive recurrence remains limited. This review examines the role of nutritional care within TRD relapse prevention, with particular attention to psychiatric nursing practise. Available dietary intervention studies in depression suggest potential benefits for depressive symptoms and broader health outcomes, but most have focused on acute treatment rather than recurrence or maintenance, and data specific to TRD remain sparse. Evidence for nurse-delivered nutritional interventions is also limited, although studies in broader psychiatric populations indicate that dietary assessment, education, behavioural support and follow-up can be incorporated into mental health care. In TRD, psychiatric nurses may contribute through nutritional risk screening, monitoring of appetite, intake, weight and physical health, reinforcement of agreed dietary recommendations, and coordination of specialist referral. Clear professional boundaries are required when malnutrition, eating disorders, refeeding risk, therapeutic diets or clinically significant nutrient–drug interactions are present. Nutritional care should therefore be regarded as an adjunct to established TRD treatment and integrated into multidisciplinary continuation and relapse-prevention care rather than used as a stand-alone intervention.