A COMPARISON OF NEFAZODONE , THE COGNITIVE BEHAVIORAL-ANALYSIS SYSTEM OF PSYCHOTHERAPY , AND THEIR COMBINATION FOR THE TREATMENT OF CHRONIC DEPRESSION N E FA Z O D O N E , P SYC H OT H E R A P Y , A N D T H E I R C O M B I N AT I O N F O R T H

  • Keller M
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Abstract

Background Patients with chronic forms of major depression are difficult to treat, and the relative effi- cacy of medications and psychotherapy is uncertain. Methods We randomly assigned 681 adults with a chronic nonpsychotic major depressive disorder to 12 weeks of outpatient treatment with nefazodone (maximal dose, 600 mg per day), the cognitive be- havioral-analysis system of psychotherapy (16 to 20 sessions), or both. At base line, all patients had scores of at least 20 on the 24-item Hamilton Rating Scale for Depression (indicating clinically significant depression). Remission was defined as a score of 8 or less at weeks 10 and 12. For patients who did not have remission, a satisfactory response was defined as a reduction in the score by at least 50 percent from base line and a score of 15 or less. Raters were unaware of the patients’ treatment assignments. Results Of the 681 patients, 662 attended at least one treatment session and were included in the analy- sis of response. The overall rate of response (both re- mission and satisfactory response) was 48 percent in both the nefazodone group and the psychotherapy group, as compared with 73 percent in the combined- treatment group (P

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  • M B. Keller

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