The DOI matches its Crossref record.
Residual Symptoms in Depressed Patients Who Respond Acutely to Fluoxetine
Abstract
BACKGROUND: Antidepressants have unequivocal efficacy as compared with placebo, but many patients have residual symptoms despite a robust response to antidepressant therapy. The purpose of this study is to assess residual symptoms in outpatients who respond acutely to fluoxetine. METHOD: Two hundred and fifteen outpatients with major depressive disorder as assessed with the Structured Clinical Interview for DSM-III-R (SCID-P) were treated openly with fluoxetine 20 mg/day for 8 weeks. One hundred and eight (50.2%) were considered full responders (final 17-item Hamilton Rating Scale for Depression [HAM-D] score < or =7). Percentages of full responders who continued to have subthreshold or full major depressive disorder symptoms were calculated. The relationship between residual symptoms and Axis I and Axis II (assessed with SCID-II for personality disorders) comorbidity was assessed. RESULTS: Of the 108 responders, 19 (17.6%) had no subthreshold or threshold SCID-P major depressive disorder symptoms, while 28 (25.9%) had 1 symptom, and 61 (56.5%) had 2 or more symptoms. No statistically significant relationships were found between number of residual symptoms and selected Axis I comorbid conditions or total number of Axis II disorders. CONCLUSION: Less than 20% of full responders to fluoxetine by HAM-D criteria were free of all SCID-P subthreshold and threshold major depressive disorder symptoms after 8 weeks of treatment. While depressed patients benefit from antidepressants, most continue to have some symptoms of depression. The high prevalence of residual symptoms among antidepressant responders suggests the need for further study including whether residual symptoms abate with longer treatment or increased dose of fluoxetine. Other strategies, such as cognitive behavioral therapy, may be needed to address residual symptoms.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
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?
In the citing paper
“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 [42]
Citations
Cited by
Sorted by citations
Items 201–300 of 465
Fava, M., McGrath, P. J., & Sheu, W.-P. (2003) · Journal of Clinical Psychopharmacology · doi:10.1097/01.jcp.0000085409.08426.4c · Cited by 35
“Such patients may experience little or no relief from their depressive symptoms, while others may experience only moderate improvements with considerable residual symptoms.(5) The presence of residual depressive symptoms among patients who respond only partially to antidepressant therapy is of particular concern as it…”
BackgroundSelf-citationNeurocognitive Impairment and Dementia in Mood Disorders
Pfennig, A., Littmann, E., & Bauer, M. (2007) · Journal of Neuropsychiatry · doi:10.1176/jnp.2007.19.4.373 · Cited by 40
Treating Depression to Improve Survival in Coronary Heart Disease
Carney, R. M., Freedland, K. E., & Rich, M. W. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2024.05.038 · Cited by 43
Rucci, P., Frank, E., Calugi, S., Miniati, M., Benvenuti, A., Wallace, M. L., Fagiolini, A. M., Maggi, L., Kupfer, D. J., & Cassano, G. B. (2011) · Depression and Anxiety · doi:10.1002/da.20894 · Cited by 33
“[2–7] According to conventions developed in the pharmacotherapy literature,[8] a relapse is defined as an episode of MDD (major depressive disorder) that occurs within 6 months after either response or remission.”
MethodNyer, M., Mischoulon, D., Alpert, J. E., Holt, D. J., Brill, C. D., Yeung, A., Pedrelli, P., Baer, L., Dording, C. M., Huz, I., et al. (2015) · Annals of Clinical Psychiatry · doi:10.1177/104012371502700204 · Cited by 39
Self-citationThe effect of escitalopram on sleep problems in depressed patients
Lader, M., Andersen, H. F., & Bækdal, T. (2005) · Human Psychopharmacology: Clinical and Experimental · doi:10.1002/hup.694 · Cited by 34
“In a fluoxetine study of the subgroup of depressive patients who achieved remission (total score HAMD 7 after 8 weeks treatment), 44% considered that they were still not sleeping well and 38% considered themselves to remain fatigued (Nierenberg et al., 1999).”
BackgroundPredictors of relapse or recurrence in bipolar I disorder
Degenhardt, E. K., Gatz, J. L., Jacob, J., & Tohen, M. F. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.09.051 · Cited by 33
Procognitive Properties of Drugs with Single and Multitargeting H3Receptor Antagonist Activities
Nikolic, K. M., Filipić, S., Agbaba, D. D., & Stark, H. (2014) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.12279 · Cited by 34
“Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressant drugs, but they do not improve cognitive function of depressive patients [133,134].”
BackgroundInsomnia in Patients with Depression
Jindal, R. D. (2009) · CNS Drugs · doi:10.2165/00023210-200923040-00004 · Cited by 33
A tale of two comorbidities: Understanding the neurobiology of depression and pain
Narasimhan, M., & Campbell, N. (2010) · Indian Journal of Psychiatry · doi:10.4103/0019-5545.64586 · Cited by 32
“These co morbid conditions also complicate treatment response and increase risk for relapse, thereby warranting the need to address both of these problems concurrently.[8,43,44] Consistent with this, timely treatment of MDD may optimize the chance of remission and minimize structural cognitive changes.”
BackgroundBindingDB (2009) · UC San Diego · doi:10.7270/q23b5zss · Cited by 33
Zimmerman, M. A., Martinez, J. H., Attiullah, N., Friedman, M. A., Toba, C., & Boerescu, D. A. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.03.044 · Cited by 32
“Consistent with the findings of other studies (Conradi et al., 2010; Cuffel et al., 2003; Iovieno et al., 2010; Nierenberg et al., 2010; Nierenberg et al., 1999), we found high rates of residual symptoms in patients who were considered to be in remission.”
ResultRobinson, D. S., Gilmor, M. L., Gilmor, M. L., PhD, Yang, Y., PhD, Moonsammy, G., PhD, Azzaro, A. J., PhD, et al. (2025) · Psychopharmacology Bulletin · doi:10.64719/pb.4106 · Cited by 31
Selecting a pharmacotherapy regimen for patients with chronic insomnia
Hassinger, A. B., Bletnisky, N., Dudekula, R., & El-Solh, A. (2020) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2020.1743265 · Cited by 34
“However, addressing the underlying medical or psychiatric condition may not always translate into the complete resolution of insomnia [55,56].”
BackgroundPerlis, R. H., Alpert, J. E., Nierenberg, A. A., Mischoulon, D., Yeung, A., Rosenbaum, J. F., & D, M. F. M. (2003) · Acta Psychiatrica Scandinavica · doi:10.1046/j.0001-690x.2003.00168.x · Cited by 31
“An additional group of patients experience some symptomatic improvement, but continue to experience residual depressive symptoms (3).”
BackgroundSelf-citationKeith, J. M., Gomez, L. A., Wolin, R. L., Barbier, A., Wilson, S. J., Boggs, J. D., Mazur, C., Fraser, I. C., Lord, B., Aluisio, L. E., et al. (2007) · Bioorganic & Medicinal Chemistry Letters · doi:10.1016/j.bmcl.2007.01.106 · Cited by 31
Treatment of sleep dysfunction and psychiatric disorders
Becker, P. M. (2006) · Current Treatment Options in Neurology · doi:10.1007/s11940-006-0026-6 · Cited by 31
Targum, S. D., Wedel, P. C., & D, M. F. M. (2015) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2015.04.024 · Cited by 31
Self-citationThe Evaluation and Management of Insomnia
Doghramji, K. (2010) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2010.03.001 · Cited by 30
Objective: remission of depression in primary care
Ansseau, M., Demyttenaere, K., Heyrman, J., Migeotte, A., Leyman, S., & Mignon, A. (2009) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2008.10.003 · Cited by 30
Lam, R. W. M. (2007) · International Clinical Psychopharmacology · doi:10.1097/01.yic.0000277959.60604.d1 · Cited by 30
“One study reported that residual symptoms were still present in 80% of remitted patients after treatment with fluoxetine (Nierenberg et al., 1999).”
BackgroundImproving outcomes in depression: A focus on somatic symptoms
McIntyre, R. S., Konarski, J. Z., Mancini, D. A., Zurowski, M., Giacobbe, P., Soczynska, J. K., & Kennedy, S. H. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2005.09.010 · Cited by 30
“These recalcitrant, subthreshold residual symptoms warrant particular clinical attention because they frequently presage relapse and functional impairment [9–14].”
BackgroundStenman, E., & Lilja, Å. (2012) · Medical Hypotheses · doi:10.1016/j.mehy.2012.10.007 · Cited by 29
“Patients successfully treated for depression frequently suffer from residual symptoms, such as concentration difficulties, decreased interest or pleasure, cognitive impairment, anxiety—and fatigue [1,2], the target of our proposed hypothesis.”
BackgroundThe impact of anxiety and migraine on quality of sleep in patients with major depressive disorder
Hsu, S., Wang, S., Liu, C., Juang, Y., Yang, C., & Hung, C. (2008) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2008.07.002 · Cited by 29
“Nierenberg et al [9] reported that sleep disturbance is the most common symptom to persist in patients with MDD in”
BackgroundSomatic Symptoms in Outpatients With Major Depressive Disorder Treated With Fluoxetine
Denninger, J. W., Papakostas, G. I., Mahal, Y., Merens, W., Alpert, J. E., Nierenberg, A. A., Yeung, A., & D, M. F. M. (2006) · Psychosomatics · doi:10.1176/appi.psy.47.4.348 · Cited by 30
Self-citationAdjunctive atomoxetine for residual fatigue in major depressive disorder
Papakostas, G. I., PETERSEN, T., BURNS, A., & D, M. F. M. (2005) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2005.04.013 · Cited by 29
“For example, more than one-in-three fluoxetine-remitters reported residual fatigue in one open-label study (Nierenberg et al., 1999).”
BackgroundSelf-citationMatsumoto, H., Hyman, J. E., Shah, H. H., Sankar, W. N., Laine, J. C., Mehlman, C. T., Schrader, T., Kelly, D. M., Rosenfeld, S. B., Janicki, J. A., et al. (2019) · Journal of Pediatric Orthopaedics · doi:10.1097/bpo.0000000000001423 · Cited by 28
Schennach, R., Feige, B., Riemann, D. W., Heuser, J., & Voderholzer, U. (2019) · Journal of Sleep Research · doi:10.1111/jsr.12842 · Cited by 31
“(1999), for example, examined 215 outpatients with a major depressive disorder receiving fluoxetine and found 82% of the patients achieved remission and sleep prob‐ lems were prominent in 44% of those in remission (Nierenberg et al., 1999).”
BackgroundInfluentialKeith, J. M., Gomez, L. A., Barbier, A., et al. (2007) · Bioorganic & Medicinal Chemistry Letters · doi:10.1016/j.bmcl.2007.03.043 · Cited by 28
Insomnia Diagnosis, Assessment, and Evaluation
Ong, J. C., Arnedt, J. T., & Gehrman, P. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-24288-2.00083-0 · Cited by 34
Association between residual symptoms and social functioning in patients with depression
Wang, Y., Wang, G., Zhang, N., Jizhong, H., Wu, W., Jia, F., Liu, T., Gao, C., Hu, J., Hong, W., et al. (2020) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2020.152164 · Cited by 28
Borentain, S., Williamson, D., Turkoz, I., Popova, V., McCall, W. V., Mathews, M., & Wiegand, F. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s339090 · Cited by 27
Perugi, G., Canonico, P. L., Carbonato, P., Mencacci, C., Muscettola, G., Pani, L., Torta, R., Vampini, C., Fornaro, M., Parazzini, F., et al. (2011) · Psychopathology · doi:10.1159/000319848 · Cited by 28
Modafinil in the treatment of excessive daytime sleepiness.
Valentino, R., & Foldvary-Schaefer, N. (2007) · Cleveland Clinic journal of medicine · doi:10.3949/ccjm.74.8.561 · Cited by 32
Fatigue in a cohort of geriatric patients with and without Parkinson's disease
Goulart, F. O., Veiga, B. A. D. A. G., Borges, V., Gomes, S. M. C. D. A. S. M. M., Mendes, M. F., Cendoroglo, M. S., & Ferraz, H. B. (2009) · Brazilian Journal of Medical and Biological Research · doi:10.1590/s0100-879x2009000800014 · Cited by 27
“Even in successfully treated patients, fatigue may persist in 10 to 35% of major depression cases (5,6).”
BackgroundAssessment of subclinical symptoms and psychological well-being in depression
Fava, G. A., & Mangelli, L. (2001) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/bf03035127 · Cited by 24
Treatment strategies for sleep disturbance in patients with depression.
Doghramji, K. (2003) · PubMed · Cited by 27
Vortioxetine for the Treatment of Depression
Pearce, E. F., & Murphy, J. A. (2014) · Annals of Pharmacotherapy · doi:10.1177/1060028014528305 · Cited by 27
Taylor, H. L., Rybarczyk, B. D., Nay, W. T., & Leszczyszyn, D. J. (2015) · Journal of Clinical Psychology · doi:10.1002/jclp.22186 · Cited by 28
“Nierenberg et al., (1999) found insomnia to be the most common persistent residual symptom in individuals who complete depression treatment, with 44% of full responders in their study reporting continued symptoms of insomnia at post-treatment.”
BackgroundResidual symptoms in depressed patients who successfully respond to short-term psychotherapy
Ogrodniczuk, J. S. (2004) · Journal of Affective Disorders · doi:10.1016/j.jad.2004.03.007 · Cited by 26
The relationship between somatic symptoms and depression.
Han, H., Wang, S. M., Han, C., Lee, S. J., & Pae, C. U. (2014) · PubMed · Cited by 26
Ly, K. S., Letavic, M. A., Keith, J. M., et al. (2007) · Bioorganic & Medicinal Chemistry Letters · doi:10.1016/j.bmcl.2007.11.016 · Cited by 26
Pan, Y., Cheng, I.-C., Yeh, L., Cho, Y.-M., & Feng, J. (2013) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2013.03.003 · Cited by 25
Lam, J. Y., Freeman, M. K., & Cates, M. E. (2007) · Annals of Pharmacotherapy · doi:10.1345/aph.1h526 · Cited by 25
Barriers to achieving treatment goals: A focus on sleep disturbance and sexual dysfunction
Morehouse, R. L., MacQUEEN, G. M., & Kennedy, S. H. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.03.047 · Cited by 25
Bertilsson, M., Vaez, M., Wærn, M., Ahlborg, G., & Hensing, G. K. E. (2014) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-014-9518-5 · Cited by 24
“and associated with slow clinical improvement were considered as confounders [23–25].”
BackgroundDevelopment and validation of a patient-report measure of fatigue associated with depression
Matza, L. S., Phillips, G. A., Revicki, D. A., Murray, L. T., & Malley, K. G. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.06.028 · Cited by 24
“Fatigue is also a frequent residual symptom that may persist in roughly 20% to 38% of patients whohave remitted following treatment (Barkhamet al., 1996; Nierenberg et al., 1999, 2010).”
BackgroundInfluentialSpanish adaptation of the Dimensional Anhedonia Rating Scale (DARS)
Arrua-Duarte, E., Migoya-Borja, M., Barrigón, M. L., Barahona, I., Delgado‐Gómez, D., Courtet, P., Aroca, F., Rizvi, S. J., Kennedy, S. H., Quilty, L. C., et al. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.11.040 · Cited by 23
Fairholme, C. P., Carl, J. R., Farchione, T. J., & Schonwetter, S. W. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.03.011 · Cited by 23
“Sleep disturbance is a common residual symptom following treatment for anxiety (Belleville, Guay, & Marchand, 2011) and mood disorders (Nierenberg et al., 1999).”
BackgroundTherapieresistenz auf Antidepressiva
Møller, H. J. (2004) · Der Nervenarzt · doi:10.1007/s00115-004-1728-1 · Cited by 23
Fairholme, C. P., & Manber, R. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.01.001 · Cited by 21
“The fact that these psychological factors contribute to poor sleep above and beyond trait vulnerabilities for emotional disorders and state negative affect may explain why poor sleep is a common residual symptom following treatment of anxiety and depression [22–24].”
BackgroundSleep complaints in adolescent depression: one year naturalistic follow-up study
Study group the Adolescent Depression, Urrila, A. S., Karlsson, L., Kiviruusu, O. H., Pankakoski, M., Pelkonen, M. U. I., Strandholm, T., & MARTTUNEN, M. J. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0283-y · Cited by 22
“During recovery from depression sleep problems often persist: they rank among the most common residual symptoms in both adult [4-6] and adolescent patients [7-9].”
BackgroundRelationship Between Residual Symptoms of Depression and Self-reported Cognitive Impairment
Pedrelli, P., Baer, L., Iosifescu, D. V., & D, M. F. M. (2010) · CNS Spectrums · doi:10.1017/s1092852900000298 · Cited by 23
“Measures HANDS The HANDS consists of 10 questions pertaining to depressive symptoms, which are rated depending on their frequency using a scale ranging from none of the time (0) to all of the time (3).”
MethodSelf-citationDunlop, B. W., Polychroniou, P. E., Rakofsky, J. J., Nemeroff, C. B., Craighead, W. E., & Mayberg, H. S. (2018) · Psychological Medicine · doi:10.1017/s0033291718002568 · Cited by 20
“The most commonly reported residual symptoms among medication-treated MDD patients are insomnia or hypersomnia (Nierenberg et al., 1999, 2010; Carney et al., 2007; Romera et al., 2014), fatigue (Nierenberg et al., 1999, 2010; Romera et al., 2014), sad mood (Nierenberg et al., 2010; Romera et al.,…”
BackgroundInfluentialAddressing circadian rhythm disturbances in depressed patients
Lam, R. W. M. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108092591 · Cited by 23
Assessment Techniques for Insomnia
Spielman, A. J., Yang, C., & Glovinsky, P. B. (2011) · Elsevier eBooks · doi:10.1016/b978-1-4160-6645-3.00144-4 · Cited by 22
Zimmerman, M. A., Posternak, M. A., McGlinchey, J. B., Friedman, M., Attiullah, N., & Boerescu, D. A. (2006) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2005.07.004 · Cited by 22
“Second, the bgold standardQ definition of remission, a cutoff of 7 on the HRSD, has been questioned by some investigators who have suggested that this cutoff score is too high [19,20].”
BackgroundPotential of St John's Wort for the Treatment of Depression: The Economic Perspective
Solomon, D., Ford, E., Adams, J., & Graves, N. (2010) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048674.2010.526094 · Cited by 21
Vieira, W. F., Iosifescu, D. V., McEachern, K. M., Gersten, M. B., & Cassano, P. (2023) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2023.02.013 · Cited by 23
Bobo, W. V., & Shelton, R. C. (2010) · Expert Review of Neurotherapeutics · doi:10.1586/ern.10.44 · Cited by 22
Immediate Switching of Antidepressant Therapy: Results from a Clinical Trial of Duloxetine
Wohlreich, M. M., Mallinckrodt, C. H., Watkin, J. G., wilson, M., Greist, J., Delgado, P. L., & D, M. F. M. (2005) · Annals of Clinical Psychiatry · doi:10.1080/10401230500296402 · Cited by 21
Self-citationShimodera, S., Watanabe, N., Furukawa, T. A., Katsuki, F., Fujita, H., Sasaki, M., & Perlis, M. L. (2014) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.3624 · Cited by 20
“The entry criteria were as follows: (1) refractory depression, defined as currently partially remitted, mild, or moderate major depressive disorder (diagnosed with DSM-IV), even after being on maximum doses of 2 types of antidepressants ≥ 4 weeks each for the index episode; (2) chronic comorbid insomnia; (3) a score b…”
Grover, S., Chakrabarti, S., & Sahoo, S. (2020) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_760_19 · Cited by 22
“[16,17] Similarly, remission for bipolar depression has been proposed as either a Hamilton Depression Rating Scale score (HAM‐D 17) of ≤7 or ≤5,[15,18] Montgomery Asberg Depression Rating Scale score of ≤7 or ≤5,[19] or Bipolar Depression Rating Scale of ≤8.”
MethodMcCall, W. V., Benca, R. M., Rosenquist, P. B., Riley, M. A., Hodges, C., Gubosh, B., McCloud, L., Newman, J. C., Case, D., Rumble, M. E., et al. (2015) · Clinical Trials · doi:10.1177/1740774515573958 · Cited by 20
“Treatment of depression with antidepressant medication is not always a sufficient means to relieve insomnia, as (1) antidepressants work relatively slowly, over weeks,(20) and (2) insomnia is the symptom of depression least likely to resolve with what otherwise would be considered a successful course of antidepressant…”
BackgroundFatigue and occupational functioning in major depressive disorder
Lam, R. W. M., Malhi, G. S., McIntyre, R. S., Demyttenaere, K., Gorwood, P. A. P. M., Michalak, E. E., & Hegerl, U. (2013) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867413488222 · Cited by 19
“For example, over 80% of outpatients with MDD treated with fluoxetine in full remission continued to exhibit one or more residual depressive symptoms; fatigue, with a 39% preva lence rate, was amongst the three most common residual symptoms (Nierenberg et al., 1999).”
BackgroundDeng, X., Liang, J. T., Liu, J., et al. (2007) · Organic Process Research & Development · doi:10.1021/op700183q · Cited by 20
Specific treatment of residual fatigue in depressed patients.
(2004) · PubMed Central · Cited by 23
Kallestad, H., Hansen, B., Langsrud, K., Ruud, T., Morken, G., Stiles, T. C., & Gråwe, R. W. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-186 · Cited by 19
“Moreover, 40%-70% of patients successfully treated for depression still experience sleep disturbance after treatment [3,5], and these patients may be at a higher risk of relapses into new episodes [6].”
BackgroundEpstein, I., Szpindel, I., & Katzman, M. A. (2014) · Psychiatry Research · doi:10.1016/s0165-1781(14)70003-4 · Cited by 18
“symptoms may also be reflective of an underlying unrecognized comorbid psychiatric or medical condition (Nierenberg et al., 1999; Kessler et al., 2006).”
BackgroundInfluentialScherf‐Clavel, M., Hommers, L. G., Wurst, C., Stonawski, S., Deckert, J., Domschke, K., Unterecker, S., & Menke, A. (2020) · Journal of Psychopharmacology · doi:10.1177/0269881120936509 · Cited by 20
Group Cognitive-Behavioral Therapy for Insomnia in a VA Mental Health Clinic
Perlman, L. M., Arnedt, J. T., Earnheart, K. L., Gorman, A. A., & Shirley, K. G. (2008) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2008.05.003 · Cited by 18
Symptoms of depression and insomnia in older age: A within‐individual analysis over 20 years
Brouwer, A., van de Ven, P., Kok, A. A. L., Snoek, F., Beekman, A., & Bremmer, M. (2022) · Journal of The American Geriatrics Society · doi:10.1111/jgs.17765 · Cited by 14
Brush, C. J., Burani, K., Schmidt, K. M., Santopetro, N. J., & Hajcak, G. (2021) · Behaviour Research and Therapy · doi:10.1016/j.brat.2021.103914 · Cited by 18
Psychiatric Comorbidity: The Case for Treating Insomnia
Krystal, A. D. (2006) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2006.06.007 · Cited by 17
van Dijk, J. P., Havlíková, E., Rosenberger, J., Nagyová, I., Škorvánek, M., Gdovinová, Z., Lok, W., Groothoff, J. W., & Middel, B. (2013) · European Neurology · doi:10.1159/000351779 · Cited by 17
Sun, Q., & Tan, L. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112514 · Cited by 16
Psychological and Behavioral Treatments for Insomnia II
Edinger, J. D., Leggett, M. K., Carney, C. E., & Manber, R. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-24288-2.00086-6 · Cited by 17
Yang, H., Sinicropi-Yao, L., Chuzi, S. E., Youn, S. J., Clain, A. J., Baer, L., Chen, Y., McGrath, P. J., D, M. F. M., & Papakostas, G. I. (2010) · Annals of General Psychiatry · doi:10.1186/1744-859x-9-10 · Cited by 16
“In addition, insomnia and hypersomnia appear to be among the most common residual symptoms following selective serotonin reuptake inhibitor (SSRI) treatment [13-15] and, often, require the use of specialized therapeutic interventions above and beyond the use of antidepressant monotherapy to ensure their full resolutio…”
BackgroundSelf-citationEvaluation of the Insomnia Patient
Arnedt, J. T., Conroy, D. A., Posner, D. A., & Aloia, M. S. (2006) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2006.06.002 · Cited by 16
Sugimoto, S. (2013) · TSpace (University of Toronto) · Cited by 16
Dai, K., Liu, X., Hu, J., Ren, F., Jin, Z., Xu, S., & Cao, P. (2024) · Frontiers in Neuroscience · doi:10.3389/fnins.2024.1290345 · Cited by 16
“MDD patients comorbid with insomnia, a common residual symptom of MDD, often have negative outcomes including incomplete treatment response, higher rates of relapse and increased medical morbidity (Nierenberg et al., 1999; Nelson et al., 2005; Léger et al., 2002).”
BackgroundPitanupong, J., Sathaporn, K., & Tepsuan, L. (2022) · Annals of General Psychiatry · doi:10.1186/s12991-022-00427-w · Cited by 16
“In addition, the most common residual depressive symptoms were sleeping problems, loss of pleasure, and poor appetite; and it might be possible that these specific symptoms of depression did not respond as well to SSRIs.”
BackgroundResultInfluentialThe Fatigue Associated with Depression Questionnaire (FAsD): responsiveness and responder definition
Matza, L. S., Wyrwich, K. W., Phillips, G. A., Murray, L. T., Malley, K. G., & Revicki, D. A. (2012) · Quality of Life Research · doi:10.1007/s11136-012-0142-6 · Cited by 15
“Several studies suggest that fatigue is frequently a residual symptom, persisting in roughly 20 to 38% of patients who have remitted following pharmacological treatment or psychotherapy [9, 17, 18].”
BackgroundInfluentialCognitive and behavioral factors in insomnia comorbid with depression and anxiety
Tsai, Y.-L., Chen, C.-W., Cheng, H.-C., Chang, C.-H., Chen, C.-Y., & Yang, C. (2013) · Sleep and Biological Rhythms · doi:10.1111/sbr.12030 · Cited by 15
Morin, C. M., Edinger, J. D., Krystal, A. D., Buysse, D. J., Beaulieu‐Bonneau, S., & Ivers, H. (2016) · Trials · doi:10.1186/s13063-016-1242-3 · Cited by 16
“When insomnia occurs co-morbid to a psychiatric illness such as major depression, it complicates disease management and often remains as a residual symptom that enhances risk for both suicide and relapse [11–13].”
BackgroundResidual Symptoms After Treatment for Depression in Patients With Coronary Heart Disease
Carney, R. M., Freedland, K. E., Steinmeyer, B. C., Rubin, E. H., & Rich, M. W. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000570 · Cited by 14
Novel naphthyridines are histamine H3 antagonists and serotonin reuptake transporter inhibitors
Letavic, M. A., Keith, J. M., Ly, K. S., et al. (2007) · Bioorganic & Medicinal Chemistry Letters · doi:10.1016/j.bmcl.2007.02.006 · Cited by 15
Residual symptoms in depression
Sonino, N., & Fava, G. A. (2002) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/s0278-5846(02)00200-2 · Cited by 15
Number of illness episodes as predictor of residual symptoms in major depressive disorder
Serafini, G., Nebbia, J., Cipriani, N., Conigliaro, C., Erbuto, D., Pompili, M., & Amore, M. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.026 · Cited by 11
Effects of dopamine modulation on chronic stress-induced deficits in reward learning
Lamontagne, S. J., Wash, S. I. J., Irwin, S. H., Zucconi, K. E., & Olmstead, M. C. (2022) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-022-01001-3 · Cited by 18
New Perspectives on Treatment of Depression in Coronary Heart Disease
Carney, R. M., & Freedland, K. E. (2023) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001219 · Cited by 16
The keys to improving depression outcomes
Rizvi, S. J., & Kennedy, S. H. (2011) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2011.07.002 · Cited by 14
“For example, sleep disturbance is a common symptom in depression and is a frequent residual symptom even in remission (Nierenberg et al., 1999).”
BackgroundPsychosocial determinants of recovery in depression
Fava, G. A., & Visani, D. (2008) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2008.10.4/gafava · Cited by 15
Management of incomplete remission and treatment resistance in first-episode psychosis
Lambert, M., Naber, D., & Huber, C. G. (2008) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.9.12.2039 · Cited by 13
Management of Chronic Depressive Patients with Residual Symptoms
Han, C., Yeh, T. L., Kato, M., Sato, S., Chang, C., & Pae, C.-U. (2013) · CNS Drugs · doi:10.1007/s40263-012-0034-x · Cited by 12
“Residual symptoms and partial response are associated with an increased risk of relapse, faster time to relapse, a more severe and chronic course and increased functional impairment [2, 3].”
BackgroundSymptoms that remain after depression treatment in patients with coronary heart disease
Carney, R. M., Freedland, K. E., Steinmeyer, B. C., & Rich, M. W. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111122 · Cited by 13
Hamoen, A., Redlich, E. M., & de Weerd, A. (2014) · Depression and Anxiety · doi:10.1002/da.22258 · Cited by 12
“Also, rapid eye movement (REM) latency is often shortened,[7] In mood disorders, insomnia frequently appears before or at the same time as the onset of the symptoms of the disorder[8] and in about half of treated depressed patients sleep problems persist after depression treatment.[9] Insomnia can have a negative impa…”
BackgroundBiogenetic temperament and character in insomnia and depression
Lee, S., Kim, S. J., Park, J. E., Cho, S., Cho, I. H., & Lee, Y. J. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.01.016 · Cited by 12
“In addition, insomnia is the most frequent residual symptom after treatment of MDD [13].”
BackgroundAhles, J. J., Mezulis, A. H., & Crowell, S. E. (2017) · Developmental Psychobiology · doi:10.1002/dev.21518 · Cited by 12
Higson‐Sweeney, N., Loades, M. E., Hiller, R. M., & Read, R. K. (2019) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104519838573 · Cited by 12
“In adult patients with depression, 20–38% of remitted patients still had substantial fatigue (Nierenberg et al., 2010; Nierenberg et al., 1999), suggesting that evidence-based treatments including pharmacological and psychological treatments may not fully address this symptom, which could pose a risk of relapse in rec…”
Background
Metadata
- Authors
- Nierenberg, A. A., Keefe, B. R., Leslie, V. C., Alpert, J. E., Pava, J. A., Worthington, J. J., Rosenbaum, J. F., & Fava, M.
- Affiliations
- Massachusetts General Hospital (US)
- Harvard University (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 1999-04-15
- Volume
- 60
- Issue
- 4
- Pages
- 221-225
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2056454671
- Cited by
- 470
- References
- 0
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 13 · 2023: 13 · 2022: 11 · 2021: 10 · 2020: 9 · 2019: 19 · 2018: 10 · 2017: 8 · 2016: 16 · 2015: 22 · 2014: 17 · 2013: 19 · 2012: 30
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r01mh048483-01a1)
- National Institute of Mental Health (R01 MH48483-01)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- residual depressive symptoms, fluoxetine, major depressive disorder, antidepressant response, subthreshold depression, comorbidities, personality disorders, outpatients, cognitive behavioral therapy
- MeSH terms
- Adult, Ambulatory Care, Depressive Disorder, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Fluoxetine, Humans, Male, Middle Aged, Personality Disorders, Psychiatric Status Rating Scales, Comorbidity, Cognitive Behavioral Therapy, Prevalence, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Age of Onset
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
