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

Traditionally thought of as an episodic, remitting illness, major depressive disorder often has a chronic course, with protracted episodes or incomplete remission between episodes. 1 – 3 At any given time, at least 3 percent of the U.S. population suffers from chronic depression. 4 , 5 Chronic forms of major depression are associated with more marked impairments in psychosocial function and work performance, 6 – 8 increased health care utilization, 5 , 9 and more frequent suicide attempts and hospitalization 10 than acute depression. Because they frequently begin early in life 11 and are often lifelong, chronic forms of major depression account for an inordinate proportion of the enormous burden . . .