Document Type
Article
Original Publication Date
2000
Journal/Book/Conference Title
The New England Journal of Medicine
Volume
342
Issue
20
First Page
1462
Last Page
1470
DOI of Original Publication
10.1056/NEJM200005183422001
Date of Submission
January 2015
Abstract
Background
Patients with chronic forms of major depression are difficult to treat, and the relative efficacy 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 behavioral-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 analysis of response. The overall rate of response (both remission 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
Conclusions
Although about half of patients with chronic forms of major depression have a response to short-term treatment with either nefazodone or a cognitive behavioral-analysis system of psychotherapy, the combination of the two is significantly more efficacious than either treatment alone.
Rights
From The New England Journal of Medicine, Keller, M.B., McCullough, J.P., Klein, D.N., et al., A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression, Vol. 342, Page 1462, Copyright © 2000 Massachusetts Medical Society. Reprinted with permission.
Is Part Of
VCU Psychology Publications
Comments
Originally published at http://dx.doi.org/10.1056/NEJM200005183422001
This article was updated on July 19, 2001, at NEJM.org. The correction was published as follows:
A Comparison of Nefazodone, the Cognitive Behavioral-Analysis System of Psychotherapy, and Their Combination for the Treatment of Chronic Depression (Original Article, N Engl J Med2000:342;1462 1470) . On page 1464, the definition of response and remission that begins on line 18 in the left-hand column should have read, “Remission was defined a priori as an HRSD score of no more than 8 at both week 10 and week 12 for the analysis of those who completed the 12-week protocol, and at end point for the analysis of the modified intention-to-treat sample. A satisfactory therapeutic response was defined as a reduction in the HRSD score by at least 50 percent from base line to week 10 and week 12, with a total score of 15 or less at these times but of more than 8 at week 10, week 12, or both, for the analysis of those who completed the study, and at end point for the analysis of the modified intention-to-treat sample.”