Combined Treatment Is Best for Chronic Depression

Chronic depression affects 3% ofthe U.S. population and accounts disproportionately for the societal burden of depressive illness. Both medication and psychotherapy are effective, although the advantage of combining treatments, as clinicians most often recommend, is unclear. This large, multicenter study compared 12-week clinical efficacy of the antidepressant nefazodone (minimum, 300 mg), cognitive-behavioral analysis (a brief interpersonal therapy), and combined treatment in 681 adults with chronic depression (minimum score on Hamilton Rating Scale for Depression, 20; duration ofillness, 2 years).

Although all groups showed significant improvement, combination treatment was superior to single treatment. Medication effects (mean dose in int…