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Proc Natl Acad Sci U S A. 2003 Nov 25;100(24):14293-6. Epub 2003 Nov 13.

Differential responses to psychotherapy versus pharmacotherapy in patients with chronic forms of major depression and childhood trauma.

Author information

1
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322. cnemero@emory.edu

Erratum in

  • Proc Natl Acad Sci U S A. 2005 Nov 8;102(45):16530.

Abstract

Major depressive disorder is associated with considerable morbidity, disability, and risk for suicide. Treatments for depression most commonly include antidepressants, psychotherapy, or the combination. Little is known about predictors of treatment response for depression. In this study, 681 patients with chronic forms of major depression were treated with an antidepressant (nefazodone), Cognitive Behavioral Analysis System of Psychotherapy (CBASP), or the combination. Overall, the effects of the antidepressant alone and psychotherapy alone were equal and significantly less effective than combination treatment. Among those with a history of early childhood trauma (loss of parents at an early age, physical or sexual abuse, or neglect), psychotherapy alone was superior to antidepressant monotherapy. Moreover, the combination of psychotherapy and pharmacotherapy was only marginally superior to psychotherapy alone among the childhood abuse cohort. Our results suggest that psychotherapy may be an essential element in the treatment of patients with chronic forms of major depression and a history of childhood trauma.

PMID:
14615578
PMCID:
PMC283585
DOI:
10.1073/pnas.2336126100
[Indexed for MEDLINE]
Free PMC Article

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