CoChat
Sign Up
Cited by 102Sleep and related disordersTreatment of Major DepressionPsychotherapy Techniques and Applications

The effects of psychotherapy, nefazodone, and their combination on subjective assessment of disturbed sleep in chronic depression

Manber, Rachel, Rush, A. John, Thase, Michael E, Arnow, Bruce, Klein, Dan, Trivedi, Madhukar H., Korenstein, Susan G., Markowitz, John C. +4 more·2003·SLEEP
DOI 10.1093/sleep/26.2.130
Open this paper in CoChat — free account

Abstract

STUDY OBJECTIVES: The purpose of the study was to compare the effects of psychotherapy, nefazodone, and their combination on subjective measures of sleep in patients with chronic forms of major depression. DESIGN: Participants were randomized to receive 12 weeks of treatment with one of the three interventions. SETTING: The study was conducted in parallel at 12 academic institutions and was approved by the Human Subjects Committee at each site. PARTICIPANTS: 484 adult outpatients (65.29% female) who met DSM-IV criteria for one of three chronic forms of major depression. INTERVENTIONS: Psychotherapy (16-20 sessions) was provided by certified therapists following a standardized treatment manual for Cognitive Behavioral Analysis System of Psychotherapy (CBASP), a variant of cognitive psychotherapy developed for chronic depression. Pharmacotherapy consisted of open-label nefazodone, 300-600 mg per day in two divided doses prescribed by psychiatrists. The clinical management visits were limited to 15-20 minutes and followed a standardized protocol. Combination treatment consisted of both therapies. MEASUREMENTS AND RESULTS: Depression outcome was determined by the 24-item Hamilton Rating Scale for Depression and the 30-item Inventory of Depressive Symptomatology-Self Rating. Sleep outcome was measured prospectively with daily sleep diaries that were completed a week prior to HRSD assessments at baseline and after 1, 2, 3, 4, 8, and 12 weeks of treatment. Although nefazodone alone and CBASP alone had comparable impact on global measures of depression outcome, only monotherapy with nefazodone improved early morning awakening and total sleep time. Significant improvements in sleep quality, time awake after sleep onset, latency to sleep onset, and sleep efficiency were present in each of the three treatment groups. These improvements, however, occurred earlier in the course of treatment for participants receiving nefazodone, alone or in combination with CBASP. CONCLUSIONS: Nefazodone therapy may have a direct impact on disturbed sleep associated with depression beyond what would be expected if the improvements were all a consequence of improved depression.

Integrity signals

Registry

Crossref · 10.1093/sleep/26.2.130

Cites

29 of 29 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

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?

  • Longitudinal studies suggest that insomnia increases the risk of developing a psychiatric condition, and that treatment of the psychiatric condition does not necessarily resolve disturbed sleep.

    “Longitudinal studies suggest that insomnia increases the risk of developing a psychiatric condition [6,40,41]; these studies also suggest that the treatment of the psychiatric condition does not necessarily resolve disturbed sleep [42,43].”

    From Non-Pharmacological Treatment of Insomnia (2012) · cites this paper as [43]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Manber, R., Rush, A. J., Thase, M. E., Arnow, B., Klein, D., Trivedi, M. H., Korenstein, S. G., Markowitz, J. C., Dunner, D. L., Munsaka, M., Borian, F. E., & Martin, B. K.
Affiliations
  • Stanford Medicine (US)
  • The University of Texas Southwestern Medical Center (US)
  • University of Pittsburgh (US)
  • State University of New York (US)
  • Virginia Commonwealth University (US)
  • Cornell University (US)
  • Brown University (US)
Corresponding author
Manber, Rachel
ORCID
Venue
SLEEP
Publisher
Oxford University Press (OUP)
Published
2003-03
Volume
26
Issue
2
Pages
130-136
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.1093/sleep/26.2.130
OpenAlex
W2467234609
Cited by
102
References
29
Citations by year
2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2016: 5 · 2015: 7 · 2014: 6 · 2013: 12 · 2012: 8
FWCI
8.61
Type
journal article
Language
en
Open access
closed
Locations
  • SLEEP (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
sleep disorders, nefazodone, psychotherapy, CBASP, combination therapy, sleep quality, early morning awakening, sleep latency, sleep efficiency, antidepressant effects on sleep
MeSH terms
Adolescent, Adult, Aged, Chronic Disease, Combined Modality Therapy, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Piperazines, Psychotherapy, Severity of Illness Index, Sleep Wake Disorders, Triazoles, 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