A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression
A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression
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DOI：
10.1056/nejm200005183422001
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发表时间：
2000-05-18
影响因子：
158.5
通讯作者：
Rothbaum, B
中科院分区：
文献类型：
--
作者：
Keller, MB;McCullough, JP;Rothbaum, B
背景资料：慢性形式的抑郁症患者很难治疗，药物和心理治疗的相对疗效是undetermined.Methods：我们随机分配681名成年人与慢性非精神病性抑郁症12周的门诊治疗奈法唑酮（最大剂量，600毫克，每天），认知行为分析系统的心理治疗（16至20届），或两者兼而有之。基线时，所有患者的24项汉密尔顿抑郁评定量表评分至少为20分（表明有临床意义的抑郁）。缓解定义为第10周和第12周评分≤ 8分。对于没有缓解的患者，满意的反应被定义为从基线至少减少50%的分数和15分或更少的分数。Raters不知道患者的治疗assignments.Results：在681例患者中，662人参加了至少一个疗程，并被纳入反应分析。奈法唑酮组和心理治疗组的总反应率（缓解和满意反应）均为48%，而联合治疗组为73%（P
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 the psychotherapy group, as compared with 73 percent in the combined-treatment group (P