CoChat
Sign Up
Cited by 1,331Treatment of Major DepressionPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.

A Comparison of Nefazodone, the Cognitive Behavioral-Analysis System of Psychotherapy, and Their Combination for the Treatment of Chronic Depression

Open access
Keller, Martin B., McCullough, James P., Klein, Daniel N., Arnow, Bruce, Dunner, David L., Gelenberg, Alan J., Markowitz, John C., Nemeroff, Charles B., Russell, James M., Thase, Michael E., Trivedi, Madhukar H., Blalock, Janice A., Borian, Frances E., Jody, Darlene N., DeBattista, Charles, Koran, Lorrin M., Schatzberg, Alan F., Fawcett, Jan, Hirschfeld, Robert M.A., Keitner, Gabor, Miller, Ivan, Kocsis, James H., Kornstein, Susan G., Manber, Rachel, Ninan, Philip T., Rothbaum, Barbara, Rush, A. John, Vivian, Dina, Zajecka, John·2000·New England Journal of Medicine
DOI 10.1056/nejm200005183422001
Open this paper in CoChat — free accountOpen PDF

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 in the psychotherapy group, as compared with 73 percent in the combined-treatment group. (P<0.001 for both comparisons). Among the 519 subjects who completed the study, the rates of response were 55 percent in the nefazodone group and 52 percent in the psychotherapy group, as compared with 85 percent in the combined-treatment group (P<0.001 for both comparisons). The rates of withdrawal were similar in the three groups. Adverse events in the nefazodone group were consistent with the known side effects of the drug (e.g., headache, somnolence, dry mouth, nausea, and dizziness). 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.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1056/nejm200005183422001

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 9

  1. Howland RH, 1993, Hosp Community Psychiatry, 44, 633
  2. Greenberg PE, 1993, J Clin Psychiatry, 54, 405
  3. Harrison WM, Stewart JW. Pharmacotherapy of dysthymic disorder. In: Kocsis JH, Klein DN, eds. Diagnosis and treatment of chronic depression. New York: Guilford Press, 1995:124-45.
  4. Depression Guideline Panel. Depression in primary care. Vol. 2. Treatment of major depression. Clinical practice guideline, number 5. Rockville, Md.: Agency for Health Care Policy and Research. 1993. (AHCPR publication no. 93-0551.)
  5. Rush AJ, Thase ME. Psychotherapies for depressive disorders. In: Maj M, Sartorius N, eds. World Psychiatric Association series on evidence and practice in psychiatry. Vol. 1. Depressive disorders. Chichester, England: John Wiley, 1999:161-206.
  6. Garlow SJ, Owens MJ, Nemeroff CB. Nefazodone. In: Sadock BJ, Sadock VA, eds. Kaplan & Sadock's comprehensive textbook of psychiatry. 7th ed. Vol. 2. Philadelphia: Lippincott Williams & Wilkins, 2000:2412-9.
  7. Beck AT, Rush AJ, Shaw BG, Emery G. Cognitive therapy of depression. New York: Guilford Press, 1979.
  8. First MB, Spitzer RL, Gibbon M, et al. Structured clinical interview for Axis-I DSM-IV disorders: patient edition (SCID-II, version 2.0). New York: New York State Psychiatric Institute Biometrics Research Department, 1994.
  9. Fawcett J, 1987, Psychopharmacol Bull, 23, 309

Cited by

Sorted by citations

See all 1,331

Related

See all

Metadata

Authors
Keller, M. B., McCullough, J. P., Klein, D. N., Arnow, B., Dunner, D. L., Gelenberg, A. J., Markowitz, J. C., Nemeroff, C. B., Russell, J. M., Thase, M. E., Trivedi, M. H., Blalock, J. A., Borian, F. E., Jody, D. N., DeBattista, C., Koran, L. M., Schatzberg, A. F., Fawcett, J., Hirschfeld, R. M. A., Keitner, G., Miller, I., Kocsis, J. H., Kornstein, S. G., Manber, R., Ninan, P. T., Rothbaum, B., Rush, A. J., Vivian, D., & Zajecka, J.
Affiliations
  • Brown University (US)
  • Virginia Commonwealth University (US)
  • State University of New York (US)
  • Stanford University (US)
  • University of Arizona (US)
  • Cornell University (US)
  • Emory University (US)
  • The University of Texas Medical Branch at Galveston (US)
  • University of Pittsburgh (US)
  • The University of Texas Southwestern Medical Center (US)
  • Rush University Medical Center (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2000-05-18
Volume
342
Issue
20
Pages
1462-1470
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm200005183422001
OpenAlex
W2326556724
Cited by
1,331
References
34
Citations by year
2026: 14 · 2025: 10 · 2024: 17 · 2023: 17 · 2022: 22 · 2021: 25 · 2020: 35 · 2019: 29 · 2018: 24 · 2017: 39 · 2016: 51 · 2015: 59 · 2014: 58 · 2013: 63 · 2012: 67
FWCI
49.18
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • VCU Scholars Compass (Virginia Commonwealth University) (submittedVersion)
Funders
National Institute of Mental Health (U01MH061590)
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
nefazodone, CBASP, antidepressant efficacy, treatment response, remission, adverse drug reactions
MeSH terms
Adult, Behavior Therapy, Chronic Disease, Combined Modality Therapy, Depressive Disorder, Female, Humans, Male, Piperazines, Triazoles, Cognitive Behavioral Therapy, Treatment Outcome, Antidepressive Agents, Second-Generation

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review