Original Article
A Comparison of Nefazodone, the Cognitive Behavioral-Analysis System of Psychotherapy, and Their Combination for the Treatment of Chronic Depression
N Engl J Med 2000; 342:1462-1470May 18, 2000
- Abstract
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<0.001 for both comparisons). Among the 519 subjects who completed the study, the rates of response were 55 percent in the nefazodone group and 52 percent in the psychotherapy group, as compared with 85 percent in the combined-treatment group (P<0.001 for both comparisons). The rates of withdrawal were similar in the three groups. Adverse events in the nefazodone group were consistent with the known side effects of the drug (e.g., headache, somnolence, dry mouth, nausea, and dizziness).
Conclusions
Although about half of patients with chronic forms of major depression have a response to short-term treatment with either nefazodone or a cognitive behavioral-analysis system of psychotherapy, the combination of the two is significantly more efficacious than either treatment alone.
Media in This Article
Figure 1
Mean Scores on the Hamilton Rating Scale for Depression during the 12-Week Study.Table 1
Status of the 681 Patients during the 12-Week Study, According to the Treatment Assignment.Article Activity
- Article
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 hospitalization10 than acute depression. Because they frequently begin early in life11 and are often lifelong, chronic forms of major depression account for an inordinate proportion of the enormous burden of illness associated with depression.12
Several studies have demonstrated the efficacy of antidepressants as both initial13-16 and maintenance17,18 treatment for chronic forms of major depression, but controlled clinical trials of sufficient size to examine the efficacy of psychotherapy in chronic forms of major depression are lacking.19 The combination of pharmacotherapy and psychotherapy has been recommended as the treatment of choice for depression by practice guidelines for psychiatrists20 and as the treatment of choice for chronic forms of major depression in primary care practice.21 However, the results of studies investigating whether combination treatment is superior to single treatments have been inconclusive.22-24
We present the main findings from the initial (12-week) phase of a long-term multicenter study comparing nefazodone alone, the cognitive behavioral-analysis system of psychotherapy alone,25,26 or the two in combination with regard to efficacy in the treatment of patients with chronic forms of major depression. Nefazodone has had demonstrated efficacy in placebo-controlled trials and in numerous double-blind trials of short-term treatment of major depressive disorders,27 as well as a demonstrated ability to prevent relapse after such treatment.28
The cognitive behavioral-analysis system of psychotherapy was developed specifically for the treatment of chronic forms of major depression and produced promising results in a small, open trial.29 This approach draws on many behavioral, cognitive, and interpersonal techniques used in other forms of psychotherapy.30-32 It teaches patients to focus on the consequences of their behavior and to use a social problem-solving algorithm to address interpersonal difficulties. It is more structured and directive than interpersonal psychotherapy30 and differs from cognitive therapy31 by focusing primarily on interpersonal interactions (including those with therapists). In this type of psychotherapy, patients learn how their cognitive and behavioral patterns produce and perpetuate their interpersonal problems and learn how to remedy maladaptive patterns of interpersonal behavior.
Methods
Patients
We studied outpatients, recruited from 12 academic centers between June 1996 and December 1997, who fulfilled the criteria for a chronic major depressive disorder (at least two years' duration), a current major depressive disorder superimposed on a preexisting dysthymic disorder, or a recurrent major depressive disorder with incomplete remission between episodes in a patient with a current major depressive disorder and a total duration of continuous illness of at least two years. Diagnoses were based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV),33 and were obtained with use of the Structured Clinical Interview for Axis I DSM-IV Disorders.34
To be eligible for the study, the patients had to be between the ages of 18 and 75 years and to have had a score of at least 20 on the 24-item Hamilton Rating Scale for Depression (HRSD)35 at screening and, after a two-week drug-free period, at base line. On this scale, higher scores indicate more severe depression. Laboratory tests, electrocardiography (if clinically indicated), and physical examinations were performed at the time of screening. Patients were required to discontinue taking monoamine oxidase inhibitors and fluoxetine at least four weeks before study entry, depot neuroleptic agents at least six months before entry, and other psychotropic medications at least two weeks before entry.
Patients were excluded from the study if they had any of the following: a history of seizures, abnormal findings on electroencephalography, severe head trauma, or stroke; evidence suggesting they were at high risk for suicide; a history of psychotic symptoms or schizophrenia; bipolar disorder, an eating disorder (if it had not been in remission for at least one year), obsessive–compulsive disorder, or dementia; antisocial, schizotypal, or severe borderline personality disorder; a principal diagnosis of panic, generalized anxiety, social phobia, or post-traumatic stress disorders or any substance-related abuse or dependence disorder (except those involving nicotine) within six months before the study began; absence of a response to a previous adequate trial of nefazodone or a cognitive behavioral-analysis system of psychotherapy; absence of a response to three previous adequate trials of at least two different classes of antidepressants or electroconvulsive therapy or to two previous adequate trials of empirical psychotherapy in the three years preceding the study; a serious, unstable medical condition; or a positive urine screen for drugs of abuse. Women of childbearing potential had to agree to use adequate contraception during the study. Patients were not allowed to take anxiolytic agents, sedatives, hypnotic agents, or any other types of sleep aids (pharmacologic or behavioral) during the study.
Study Design
The institutional review board at each center approved the study. All patients provided written informed consent. Patients who remained eligible at the end of the two-week evaluation period were randomly assigned, according to a central computerized randomization schedule, in a 1:1:1 ratio to receive nefazodone (Serzone, Bristol-Myers Squibb), psychotherapy, or a combination of nefazodone and psychotherapy. The Structured Clinical Interview for Axis I DSM-IV Disorders and the HRSD were administered by experienced clinical raters (study coordinators) certified to have a high rate of interrater reliability and level of procedural integrity. Each site implemented procedures to mask the patient's treatment assignment from the person who evaluated the results of the HRSD, and the degree of adherence to these procedures was monitored at each study visit. At all sites the rater was located at a separate physical location so that he or she could not see patients arriving for or departing from treatment sessions.
Among the patients who received nefazodone, the initial dose was 200 mg per day (100 mg twice a day) and was increased to 300 mg per day during the second week. Thereafter, the dose was increased weekly in increments of 100 mg per day to a maximum of 600 mg per day, to maximize the efficacy of the drug without producing intolerable side effects. To remain in the study, patients had to be receiving a dose of at least 300 mg per day by week 3.
Visits for medication were limited to 15 to 20 minutes. Psychopharmacologists followed a published manual36 for clinical management (e.g., patients were questioned about the concomitant use of medications and symptoms, side effects, and illnesses they had had between visits). The psychopharmacologists were not allowed to make formal psychotherapeutic interventions (such as suggesting ways to cope with stressful life events).
The cognitive behavioral-analysis system of psychotherapy also followed a manual37 specifying twice-weekly sessions during weeks 1 through 4 and weekly sessions during weeks 5 through 12. Twice-weekly sessions could be extended until week 8 if a patient was not adequately performing a learned social problem-solving procedure according to the criteria.
Psychotherapists (persons who had at least two years' experience after earning an M.D. or Ph.D. or at least five years' experience after earning an M.S.W.) attended a two-day training workshop and met the criteria for mastery of treatment procedures involved in the cognitive behavioral-analysis system of psychotherapy, as assessed by evaluation of their performance during two videotaped pilot cases. All psychotherapy sessions conducted during the study were videotaped, and supervisors reviewed the videotapes weekly to assess the psychotherapists' adherence to the treatment procedures.
Outcome Measures
The score on the 24-item HRSD was the primary outcome. The Global Assessment of Functioning Scale (Axis V in the DSM-IV) was administered at base line, and the results were evaluated by the same person who evaluated the HRSD results. Remission was defined a priori as an HRSD score of no more than 8 at both week 10 and week 12 for those who completed the 12-week protocol and at the time of withdrawal for those who did not complete the study. A satisfactory therapeutic response was defined as a reduction in the HRSD score by at least 50 percent from base line to week 10 and week 12, with a total score of 15 or less at these times but of more than 8 at week 10, week 12, or both for those who completed the study and at the time of departure for those who did not complete the study. The patients with these favorable outcomes were combined to form a single response group. All other patients were considered to have had no response.
Statistical Analysis
The base-line demographic and clinical characteristics of the treatment groups were compared with the use of analysis of variance for continuous variables and the Cochran–Mantel–Haenszel test for categorical variables, with site as the stratification variable. Preliminary paired t-tests were conducted separately for each treatment group to examine the significance of the changes in the HRSD scores from base line to the end point.
No outcome data were collected on patients who withdrew from the study after they withdrew, and a formal intention-to-treat analysis thus could not be performed. The primary analysis was a modified intention-to-treat analysis that included all patients who attended at least one treatment visit and who had at least one assessment after the base-line evaluation. Patients who underwent randomization but who did not return for a subsequent assessment were therefore not included in this analysis. Given this modified approach, the main efficacy analysis was a piecewise mixed-effects linear model that examined the relative differences between treatments with respect to the rate of change in the HRSD score (the linear slope) from base line to week 4 as one variable and from week 4 to week 12 (or the last visit) as a second variable. The a priori rationale for examining the first four weeks separately was that the earliest antidepressant effects of nefazodone are likely to occur at week 4 if a stable dosage has been achieved. Each model estimated fixed effects with respect to treatment and site, as well as the interactions between treatment and time. In addition, the models included a random intercept and a random slope. Interactions between treatment and site were not significant and therefore were not included in the models. The statistical significance of additional terms included in successive models was determined by the likelihood-ratio test. The error structure was specified as nonstationary autocorrelation in each model. There were no interim analyses of the data.
In addition to the mixed-model analysis, we examined response and remission rates that were based on the total HRSD score. We used the Cochran–Mantel–Haenszel test to analyze these rates in the modified intention-to-treat sample and among the patients who completed the study (with site as the stratification variable). We also performed an analysis of covariance of the change in total HRSD scores from base line to the end point, with base-line scores as the covariate, on these two samples. The model included treatment and site as the main effects. The interactions between treatment and site were again not significant and, hence, were not included in the model. We made pairwise comparisons of the means of the three treatment groups (adjusted for base-line values) using simple contrasts. Overall differences between treatments were evaluated with use of an alpha level of 0.05, whereas pairwise comparisons used an alpha level of 0.0167 (0.05 ÷ 3) with Bonferroni's correction.
We used Fisher's exact test to analyze the incidence of adverse events and rate of discontinuation of treatment in the three groups. All statistical tests were two-tailed. The data analysis was done by a biostatistical data-management company (Statprobe, Ann Arbor, Mich.), according to a plan devised by the authors. The company was selected and paid by Bristol-Myers Squibb.
Results
Base-Line Clinical and Demographic Characteristics
A total of 1035 patients were screened for the study. Of the 354 who did not undergo randomization, 235 (66 percent) did not meet the study criteria, 47 (13 percent) withdrew their consent, and 72 (20 percent) were excluded for other reasons (e.g., failure to return for further evaluation or noncompliance). A total of 681 patients underwent randomization: 226 were assigned to receive nefazodone, 228 to receive psychotherapy, and 227 to receive combined treatment (Table 1Table 1
Status of the 681 Patients during the 12-Week Study, According to the Treatment Assignment.). Randomization was not stratified according to site. At each site, approximately equal numbers of patients underwent randomization to the three groups. However, there were no significant differences among the groups with respect to base-line demographic and clinical characteristics (Table 2Table 2
Base-Line Characteristics of the Patients.), either among the sites overall or within sites.Treatment
For the modified intention-to-treat sample, the mean (±SD) final daily dose of nefazodone was 466± 144 mg in the nefazodone group (data available for 216 patients) and 460±139 mg in the combined-treatment group (221 patients). Among the patients who completed the study and for whom data on dose were available, the mean final daily dose of nefazodone was 520±100 mg among 92 patients with a response in the nefazodone group and 479±111 mg among the 152 patients with a response in the combined-treatment group. The dose was 491±125 mg among 73 patients without a response in the nefazodone group and 539±96 mg among the 27 patients without a response in the combined-treatment group.
For the modified intention-to-treat sample, the average number of psychotherapy sessions was 16.0±4.7 among 216 patients in the psychotherapy group and 16.2±4.8 among 226 patients in the combined-treatment group. Among those who completed the study, the 90 patients with a response in the psychotherapy group and the 152 such patients in the combined-treatment group attended a mean of 18.2±1.9 sessions, whereas the number was 17.7±1.9 among the 83 patients in the psychotherapy group who had no response and 17.9±1.4 among the 27 patients in the combined-treatment group who had no response.
Efficacy
Analyses revealed a significant improvement within patients in the HRSD scores from base line to week 12 in the group of patients who completed the study (P<0.001) and from base line to the last follow-up visit in the modified intention-to-treat sample (P<0.001) in all three groups. The mixed-effects piecewise linear regression examining the course of the scores during the 12 weeks of the trial (Figure 1Figure 1
Mean Scores on the Hamilton Rating Scale for Depression during the 12-Week Study.) showed that from base line through week 4, the average rate of improvement in the scores for patients in the combined-treatment group was not significantly different from the average rate of improvement in the scores for patients in the nefazodone group (P= 0.39). However, the results of the analysis of the rate of improvement in the scores as a regression slope showed significant differences between the nefazodone group and the psychotherapy group (P=0.004) and between the combined-treatment group and the psychotherapy group (P<0.001). From week 4 through week 12, the average rate of improvement in the HRSD scores for patients in the combined-treatment group was significantly larger than the rate of improvement in scores for patients in the nefazodone group (P<0.001). There was also a significant difference in the rate of improvement in scores between the psychotherapy group and the nefazodone group (P<0.001) but not between the combined-treatment group and the psychotherapy group (P=0.06).The overall rate of response was significantly higher in the combined-treatment group than in the nefazodone group or the psychotherapy group in both the modified intention-to-treat sample and the group of patients who completed the study (P<0.001 for all comparisons) (Table 3Table 3
Rates of Response and Remission.). For the modified intention-to-treat sample, the overall rates of response were 48 percent in the psychotherapy group (95 percent confidence interval, 41.5 to 54.8 percent), 48 percent in the nefazodone group (95 percent confidence interval, 41.0 to 54.3 percent), and 73 percent in the combined-treatment group (95 percent confidence interval, 68.6 to 80.1 percent) at the time of the last follow-up visit. Among the patients who completed the 12 weeks of treatment, the overall rates of response were 52 percent in the psychotherapy group (95 percent confidence interval, 44.6 to 59.6 percent), 55 percent in the nefazodone group (95 percent confidence interval, 47.5 to 62.6 percent), and 85 percent in the combined-treatment group (95 percent confidence interval, 79.7 to 90.2 percent). In both samples of patients, significantly more patients had a remission during combined treatment than during treatment with nefazodone or psychotherapy alone (P<0.001 for all comparisons) (Table 3). In the modified intention-to-treat sample, the remission rates were 33 percent in the psychotherapy group, 29 percent in the nefazodone group, and 48 percent in the combined-treatment group. The respective rates of remission among the patients who completed the study were 24 percent, 22 percent, and 42 percent.An analysis of covariance revealed significant differences between treatment groups with respect to the final HRSD scores for both the modified intention-to-treat sample (Table 4Table 4
Mean Scores on the Hamilton Rating Scale for Depression at Base Line, Week 12, and the Last Follow-up Visit.) and in the patients who completed the study, with combined treatment more effective than either psychotherapy alone or nefazodone alone (P<0.001 for all comparisons). To examine the size of the differences between combined treatment and treatment with nefazodone or psychotherapy alone, we calculated effect sizes using Cohen's d (the difference between adjusted means divided by the pooled standard deviation). The effect sizes calculated for the group of patients who completed the study and for the modified intention-to-treat sample ranged from 0.54 to 0.64 for the comparison of combined treatment with the other two groups. There were no significant differences at end point between the nefazodone group and the psychotherapy group.Rates of Discontinuation and Adverse Events
The rates of discontinuation were similar in the three groups (P=0.46) (Table 1), with 24 percent of all patients not completing the 12-week study. The percentage of patients who dropped out because of lack of efficacy was low (1 percent in each group). The rate of discontinuation due to adverse events was 14 percent in the nefazodone group, 7 percent in the combined-treatment group, and 1 percent in the psychotherapy group. The most common reason for discontinuing psychotherapy was withdrawal of consent (in 14 percent of patients). Of the 32 patients who withdrew their consent, 5 did not want psychotherapy, 11 thought treatment was too time consuming, and 4 wanted medication. Seventy-two percent of the patients in the psychotherapy group who withdrew their consent did so within the first four weeks of treatment.
Table 5Table 5
Common Adverse Events. lists the adverse events (whether or not they were thought to be related to treatment) that occurred in at least 10 percent of all patients. The adverse events in the groups receiving nefazodone were consistent with the known side effects of the medication, with headache, somnolence, dry mouth, nausea, and dizziness being the most common. Weight gain was rare, with no instances in the nefazodone or psychotherapy group and an incidence of 3.1 percent in the combined-treatment group. Sexual dysfunction (including impotence, psychosexual dysfunction, anorgasmia, and abnormal ejaculation) occurred in 3.5 percent of the patients in the nefazodone group, none of the patients in the psychotherapy group, and 3.5 percent of the patients in the combined-treatment group.Discussion
We found that treatment with a combination of nefazodone and psychotherapy had significant advantages over treatment with nefazodone or psychotherapy alone. Despite the fact that the patients had had active depression for many years and that many had other psychiatric disorders as well, among the patients who completed the study, 85 percent of the patients in the combined-treatment group had a response to treatment by week 12, as compared with 55 percent of patients in the nefazodone group and 52 percent of patients in the psychotherapy group. The rates of response and remission in the combined-treatment group were substantially higher than those that might have been anticipated on the basis of the outcomes of previous trials in similar patients. By contrast, in the modified intention-to-treat sample, the rate of response of 48 percent in both the nefazodone group and the psychotherapy group was similar to the rates reported for treatment with sertraline (52 percent),13 imipramine (51 percent),13 and desipramine (51 percent)18 in other studies of patients with chronic depression. The degree of superiority of combination therapy over monotherapy, as indicated by differences in the response rates and the sizes of the effects, suggests that combined treatment provides a clinically meaningful advantage. These results support previous recommendations,21 based on clinical experience, for the use of both psychotherapy and medication to treat patients with chronic depression.
Nefazodone produced effects more rapidly than did psychotherapy, with significant advantages evident in the first four weeks, whereas psychotherapy had a greater effect during the second part of the trial. By week 12, the efficacy of the two approaches was similar. Although patients who were receiving nefazodone had higher frequencies of adverse events than those receiving psychotherapy, the rates of withdrawal from the study were similar in all three treatment groups. The fact that the efficacy of combined treatment and nefazodone was similar during the first four weeks of the study but that combined treatment was more efficacious later in the study suggests that when medication and psychotherapy are administered together, they continue to have independent rather than synergistic mechanisms of action.
A limitation of our study was the lack of a placebo control. However, a placebo-controlled study of patients with either a chronic major depressive disorder alone or a major depressive disorder plus dysthymia reported a relatively low rate of response to placebo (12 percent).14 In a study on the treatment of chronic forms of depression, the use of a placebo control would most likely greatly decrease the number of patients willing to participate, thereby reducing the generalizability of the findings.38
Another limitation, common to all studies of psychotherapy, was our inability to mask patients and therapists in the psychotherapy groups. To counteract this limitation, we had persons who were unaware of the patients' treatment assignments administer the HRSD. However, the clinicians were obviously not unaware of the treatment that patients were receiving.
Further limitations of our study include the restrictive exclusion criteria, which also reduced the generalizability of the findings, and the rates of withdrawal in conjunction with the lack of further data on patients after they withdrew. The slightly lower rate of withdrawal in the combined-treatment group (21 percent) than in the nefazodone group (26 percent) or the psychotherapy group (24 percent) may have biased the outcome comparisons.
In summary, we found that the combination of pharmacotherapy (nefazodone) and the cognitive behavioral-analysis system of psychotherapy was significantly more efficacious than either treatment alone for outpatients with chronic forms of depression. The rates of response to either treatment alone were similar and were also similar to the rates reported in previous trials of antidepressants for the treatment of chronic forms of depression in outpatients, indicating that at least one form of psychotherapy is effective in treating such patients. Although similarly effective, nefazodone produced effects more rapidly than did psychotherapy.
Supported by Bristol-Myers Squibb.
Editor's note: Our policy requires authors of Original Articles to disclose all financial ties with companies that make the products under study or competing products. In this case, the large number of authors and their varied and extensive financial associations with relevant companies made a detailed listing in the print version of the article impractical. Details are included below and are also available (as document no. 05552) from the National Auxiliary Publications Service, c/o Microfiche Publications, 248 Hempstead Tpke., West Hempstead, NY 11552.
Dr. Keller has served as a consultant to or received honorariums from Pfizer, Bristol-Myers Squibb, Forest Laboratories/Parke-Davis, Wyeth–Ayerst, Merck, Janssen, Eli Lilly, Organon, and Pharmacia–Upjohn. He has received research grants from Wyeth–Ayerst, SmithKline Beecham, Upjohn, Pfizer, Bristol-Myers Squibb, Merck, Forest Laboratories, Zeneca, and Organon. He has served on the advisory board of Wyeth–Ayerst, Pfizer, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories/Parke-Davis, Organon, SmithKline Beecham, Merck, Janssen, Mitsubishi Pharmaceuticals, Zeneca, Scirex, and Otsuka.
Dr. Klein has served as a consultant to Bristol-Myers Squibb.
Dr. Dunner has served as a consultant to Bristol-Myers Squibb, SmithKline Beecham, Glaxo Wellcome, and Eli Lilly. He has received research grants from Bristol-Myers Squibb, Pfizer, Pharmacia–Upjohn, SmithKline Beecham, Forest Laboratories, Glaxo Wellcome, and Wyeth–Ayerst. He has received speaker's honorariums from Bristol-Myers Squibb, SmithKline Beecham, Glaxo Wellcome, Eli Lilly, Organon, and Wyeth–Ayerst.
Dr. Gelenberg has received grants and research support from Bristol-Myers Squibb, Organon, Pfizer, Lilly Research Laboratories, Janssen, Merck Sharp & Dohme, SmithKline Beecham, Wyeth–Ayerst, Hoechst Marion Roussel, and Forest Laboratories. He has been a member of speakers' bureaus sponsored by Bristol-Myers Squibb, Pfizer, SmithKline Beecham, Janssen, Lilly, Forest Laboratories, and Parke-Davis. He is a stockholder or has other ownership interest in Pfizer, Warner-Lambert, and Eli Lilly. He has served as a consultant to Eli Lilly, Scios, Forest Laboratories, Parke-Davis, Pfizer, Janus Pharmaceuticals, Best Practice, and Bristol-Myers Squibb.
Dr. Markowitz has received speaker's honorariums from Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Organon, and Pfizer.
Dr. Nemeroff has been a consultant to or received honorariums from Abbott, AstraZeneca, Bristol-Myers Squibb, Forest Laboratories, Janssen, Eli Lilly, Merck, Mitsubishi, Neurocrine Biosciences, Organon, Otsuka, Pfizer, Pharmacia–Upjohn, Sanofi, SmithKline Beecham, Solvay, and Wyeth–Ayerst. He has received research support from Abbott, AstraZeneca, Bristol-Myers Squibb, Forest Laboratories, Janssen, Eli Lilly, Organon, Pfizer, Pharmacia–Upjohn, SmithKline Beecham, Solvay, and Wyeth–Ayerst.
Dr. Russell has been a consultant to or received honorariums from Abbott, Bristol-Myers Squibb, Janssen, Eli Lilly, Pfizer, and Quintiles. He has received research support from Abbott, Bristol-Myers Squibb, Eli Lilly, Parke-Davis, Pharmacia–Upjohn, Pfizer, SmithKline Beecham, Wyeth–Ayerst, Shire, and Quintiles.
Dr. Thase has served as a consultant to Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Glaxo Wellcome/Cerenex Pharmaceuticals, Merck, Organon, Pfizer, Pharmacia–Upjohn, and Wyeth–Ayerst. He has received grant and research support from Bristol-Myers Squibb, Lipha Pharmaceuticals, Merck, Organon, Pharmacia–Upjohn, and Wyeth–Ayerst. He has been a member of speakers' bureaus sponsored by Bristol-Myers Squibb, Eli Lilly, Forest Pharmaceuticals, Glaxo Wellcome/Cerenex Pharmaceuticals, Organon, Parke-Davis, Pfizer, Pharmacia–Upjohn, SmithKline Beecham, Solvay, and Wyeth–Ayerst.
Dr. Trivedi has received research grants from Abbott, Akzo (Organon), Bayer, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Glaxo Wellcome, Janssen, Johnson & Johnson, MeadJohnson, Parke-Davis, Pfizer, Pharmacia–Upjohn, Solvay, and Wyeth–Ayerst. He has been a member of speakers' bureaus sponsored by Bristol-Myers Squibb, Forest Laboratories, Pharmacia–Upjohn, Solvay, and Wyeth–Ayerst.
Dr. Zajecka has received grants and research support from Abbott, Bristol-Myers Squibb, Eli Lilly, Glaxo Wellcome, Organon, Otsuka America, Parke-Davis, Pfizer, Pharmacia–Upjohn, and Sanofi Research. He has served as a consultant to or has served on the advisory board of Abbott, Bristol-Myers Squibb, and Eli Lilly. He has been a member of speakers' bureaus sponsored by Abbott, Bristol-Myers Squibb, Eli Lilly, Pfizer/Roerig, SmithKline Beecham, Upjohn, and Wyeth–Ayerst.
Dr. Blalock has served as a consultant to Bristol-Myers Squibb.
Dr. DeBattista has been a member of speakers' bureaus sponsored by Abbott, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Glaxo Wellcome, Parke-Davis, Pfizer, Scios, SmithKline Beecham, Wyeth–Ayerst, and Organon. He has received grants and research support from Abbott, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Glaxo Wellcome, Pfizer, the National Alliance for Research on Schizophrenia and Depression, Pharmacia–Upjohn, PharmaPrint/ABA, SmithKline Beecham, and Wyeth–Ayerst. He has served as a consultant to Bristol-Myers Squibb, Eli Lilly, Glaxo Wellcome, and PharmaPrint.
Dr. Fawcett has received grants and research support from Abbott, Bristol-Myers Squibb, Glaxo, Eli Lilly, Organon, Pfizer, SmithKline Beecham, Wyeth–Ayerst, and Zeneca. He has served as a consultant to Abbott, Bristol-Myers Squibb, Eli Lilly, EM Industries, Forest Laboratories, Glaxo Wellcome, Pfizer, Pharmacia–Upjohn, and SmithKline Beecham. He has been a member of speakers' bureaus sponsored by Abbott, Bristol-Myers Squibb, Eli Lilly, Pfizer/Roerig, Pharmacia–Upjohn, SmithKline Beecham, and Wyeth–Ayerst.
Dr. Hirschfeld has received grants and research support from Abbott, Bristol-Myers Squibb, Organon, and Pfizer. He has served as a consultant to or on the advisory board of Abbott, Bristol-Myers Squibb, Glaxo Wellcome, Forest Laboratories, Eli Lilly, Pfizer, SmithKline Beecham, Janssen, Organon, Parke-Davis, and Pharmacia–Upjohn.
Dr. Kocsis has had research contracts with Bristol-Myers Squibb, Pfizer, Forest Laboratories, Eli Lilly, and Wyeth–Ayerst. He has received speaker's honorariums from Bristol-Myers Squibb, Forest Laboratories, and Eli Lilly. He owns stock in Pfizer and Forest Laboratories.
Dr. Kornstein has received research grants from Bristol-Myers Squibb, Pfizer, Eli Lilly, Glaxo Wellcome, Forest Laboratories, Mitsubishi Pharmaceuticals, and Biovail. She has served as a consultant to Bristol-Myers Squibb, Pfizer, Eli Lilly, and Pharmacia–Upjohn. She has received honorariums from Bristol-Myers Squibb, Pfizer, and Glaxo Wellcome.
Dr. Ninan has received grants and research support from Abbott, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Organon, Pharmacia–Upjohn, SmithKline Beecham, and Solvay. He has served as a consultant to Pfizer, TAPPharma, and Wyeth–Ayerst. He has been a member of speakers' bureaus sponsored by Abbott, Bristol-Myers Squibb, Eli Lilly, Forest Laboratories, Organon, Parke-Davis, Pfizer, Pharmacia–Upjohn, SmithKline Beecham, Solvay, Janssen, and Wyeth–Ayerst.
Dr. Rothbaum has served as a consultant to Bristol-Myers Squibb and Pfizer. She has been a member of the advisory board of and a speakers' bureau sponsored by Pfizer.
Dr. Rush has received grants and research support from Abbott, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Forest Laboratories/Parke-Davis, Glaxo Wellcome, Janssen, Novartis, Organon, Pfizer, Pharmacia–Upjohn, SmithKline Beecham, Wyeth–Ayerst, and Zeneca. He has served as a consultant to Bristol-Myers Squibb, Cyberonics, Eli Lilly, Forest Laboratories/Parke-Davis, Glaxo Wellcome, Janssen, Merck, Organon, Pfizer, Pharmacia–Upjohn, and Wyeth–Ayerst. He has been a member of speakers' bureaus sponsored by Abbott, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Forest Laboratories/Parke-Davis, Glaxo Wellcome, Organon, Pfizer, Pharmacia–Upjohn, and Wyeth–Ayerst.
Dr. Schatzberg has served as a consultant to or received honorariums from Abbott, Bristol-Myers Squibb, Corcept Therapeutics, Forest Laboratories, Janssen, Eli Lilly, Merck, Mitsubishi Pharmaceuticals, Organon, Parke-Davis, Pfizer, Pharmacia–Upjohn, Sanofi, Scirex, SmithKline Beecham, Solvay, and Wyeth–Ayerst. He has received research support from Bristol-Myers Squibb, Pfizer, and SmithKline Beecham. He has equity ownership in Corcept, Merck, Pfizer, and Scirex.
We are indebted to Drs. Jack E. Carr, Pedro L. Delgado, Frank Dowling, Gregory Eaves, Robert H. Howland, and Carina Vocisano for assisting with the study.
Source Information
From the Department of Psychiatry, Brown University, Providence, R.I. (M.B.K.); the Unipolar Mood Disorders Institute, Department of Psychology, Virginia Commonwealth University, Richmond (J.P.M.); the Department of Psychology, State University of New York at Stony Brook, Stony Brook (D.N.K.); the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif. (B.A.); the Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (D.L.D.); the Department of Psychiatry, University of Arizona, Tucson (A.J.G.); the Department of Psychiatry, Cornell University Medical College, New York (J.C.M.); the Department of Psychiatry, Emory University School of Medicine, Atlanta (C.B.N.); the Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch at Galveston, Galveston (J.M.R.); the Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh (M.E.T.); the Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, Dallas (M.H.T.); and the Department of Psychiatry, Rush–Presbyterian–St. Luke's Medical Center, Chicago (J.Z.).
Address reprint requests to Dr. Keller at the Department of Psychiatry and Human Behavior, Brown University, 345 Blackstone Blvd., Providence, RI 02906.
Other authors were Janice A. Blalock, Ph.D. (M.D. Anderson Cancer Center, Houston); Frances E. Borian, R.N., and Darlene N. Jody, M.D. (Bristol-Myers Squibb, Plainsboro, N.J.); Charles DeBattista, D.M.H., M.D., Lorrin M. Koran, M.D., and Alan F. Schatzberg, M.D. (Stanford University, Stanford, Calif.); Jan Fawcett, M.D. (Rush–Presbyterian–St. Luke's Medical Center, Chicago); Robert M.A. Hirschfeld, M.D. (University of Texas Medical Branch at Galveston, Galveston); Gabor Keitner, M.D., and Ivan Miller, Ph.D. (Brown University, Providence); James H. Kocsis, M.D. (Cornell University Medical College, New York); Susan G. Kornstein, M.D. (Virginia Commonwealth University, Richmond); Rachel Manber, Ph.D. (University of Arizona, Tucson); Philip T. Ninan, M.D., and Barbara Rothbaum, Ph.D. (Emory University School of Medicine, Atlanta); A. John Rush, M.D. (University of Texas Southwestern Medical Center at Dallas, Dallas); and Dina Vivian, Ph.D. (State University of New York at Stony Brook, Stony Brook).
- References
References
1
Judd LL ,Akiskal HS ,Paulus MP . The role and clinical significance of subsyndromal depressive symptoms (SSD) in unipolar major depressive disorder. J Affect Disord 1997;45:5-18
CrossRef | Web of Science | Medline2
Keller MB ,Hanks DL ,Klein DN . Summary of the DSM-IV mood disorders field trial and issue overview. Psychiatr Clin North Am 1996;19:1-28
CrossRef | Web of Science | Medline3
Kocsis JH, Klein DN, eds. Diagnosis and treatment of chronic depression. New York: Guilford Press, 1995.
4
Kessler RC ,McGonagle KA ,Zhao S , et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry 1994;51:8-19
CrossRef | Web of Science | Medline5
Weissman MM ,Leaf PJ ,Bruce ML ,Florio L . The epidemiology of dysthymia in five communities: rates, risks, comorbidity, and treatment. Am J Psychiatry 1988;145:815-819
Web of Science | Medline6
Wells KB ,Burnam MA ,Rogers W ,Hays R ,Camp P . The course of depression in adult outpatients: results from the Medical Outcomes Study. Arch Gen Psychiatry 1992;49:788-794
Web of Science | Medline7
Hays RD ,Wells KB ,Sherbourne CD ,Rogers W ,Spritzer K . Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 1995;52:11-19
Web of Science | Medline8
Miller IW ,Keitner GI ,Schatzberg AF , et al. The treatment of chronic depression. 3. Psychosocial functioning before and after treatment with sertraline or imipramine. J Clin Psychiatry 1998;59:608-619
CrossRef | Web of Science | Medline9
Howland RH . Chronic depression. Hosp Community Psychiatry 1993;44:633-639
Medline10
Klein DN ,Norden KA ,Ferro T , et al. Thirty-month naturalistic follow-up study of early-onset dysthymic disorder: course, diagnostic stability, and prediction of outcome. J Abnorm Psychol 1998;107:338-348
CrossRef | Web of Science | Medline11
Cassano GB ,Akiskal HS ,Perugi G ,Musetti L ,Savino M . The importance of measures of affective temperaments in genetic studies of mood disorders. J Psychiatr Res 1992;26:257-268
CrossRef | Web of Science | Medline12
Greenberg PE ,Stiglin LE ,Finkelstein SN ,Berndt ER . The economic burden of depression in 1990. J Clin Psychiatry 1993;54:405-418
Web of Science | Medline13
Keller MB ,Gelenberg AJ ,Hirschfeld RMA , et al. The treatment of chronic depression. 2. A double-blind, randomized trial of sertraline and imipramine. J Clin Psychiatry 1998;59:598-607
CrossRef | Web of Science | Medline14
Kocsis JH ,Frances AJ ,Voss CB ,Mann JJ ,Mason BJ ,Sweeney J . Imipramine treatment for chronic depression. Arch Gen Psychiatry 1988;45:253-257
Web of Science | Medline15
Harrison WM, Stewart JW. Pharmacotherapy of dysthymic disorder. In: Kocsis JH, Klein DN, eds. Diagnosis and treatment of chronic depression. New York: Guilford Press, 1995:124-45.
16
Thase ME ,Fava M ,Halbreich U , et al. A placebo-controlled, randomized clinical trial comparing sertraline and imipramine for the treatment of dysthymia. Arch Gen Psychiatry 1996;53:777-784
Web of Science | Medline17
Keller MB ,Kocsis JH ,Thase ME , et al. Maintenance phase efficacy of sertraline for chronic depression: a randomized controlled trial. JAMA 1998;280:1665-1672
CrossRef | Web of Science | Medline18
Kocsis JH ,Friedman RA ,Markowitz JC , et al. Maintenance therapy for chronic depression: a controlled clinical trial of desipramine. Arch Gen Psychiatry 1996;53:769-776
Web of Science | Medline19
Markowitz JC . Psychotherapy of dysthymia. Am J Psychiatry 1994;151:1114-1121
Web of Science | Medline20
American Psychiatric Association
Web of Science | Medline21
Depression Guideline Panel. Depression in primary care. Vol. 2. Treatment of major depression. Clinical practice guideline, number 5. Rockville, Md.: Agency for Health Care Policy and Research. 1993. (AHCPR publication no. 93-0551.)
22
Rush AJ, Thase ME. Psychotherapies for depressive disorders. In: Maj M, Sartorius N, eds. World Psychiatric Association series on evidence and practice in psychiatry. Vol. 1. Depressive disorders. Chichester, England: John Wiley, 1999:161-206.
23
Roth A, Fonagy P. What works for whom? A critical review of psychotherapy research. New York: Guilford Press, 1996.
24
Conte HR ,Plutchik R ,Wild KV ,Karasu TB . Combined psychotherapy and pharmacotherapy for depression: a systematic analysis of the evidence. Arch Gen Psychiatry 1986;43:471-479
Web of Science | Medline25
McCullough JP. Treatment for chronic depression: cognitive behavioral analysis system of psychotherapy. New York: Guilford Press, 2000.
26
McCullough JP . Cognitive-behavioral analysis system of psychotherapy: an interactional treatment approach for dysthymic disorder. Psychiatry 1984;47:234-250
Web of Science | Medline27
Garlow SJ, Owens MJ, Nemeroff CB. Nefazodone. In: Sadock BJ, Sadock VA, eds. Kaplan & Sadock's comprehensive textbook of psychiatry. 7th ed. Vol. 2. Philadelphia: Lippincott Williams & Wilkins, 2000:2412-9.
28
Feiger AD ,Bielski RJ ,Bremner J , et al. Double-blind, placebo-substitution study of nefazodone in the prevention of relapse during continuation treatment of outpatients with major depression. Int Clin Psychopharmacol 1999;14:19-28
CrossRef | Web of Science | Medline29
McCullough JP . Psychotherapy for dysthymia: a naturalistic study of ten patients. J Nerv Ment Dis 1991;179:734-740
CrossRef | Web of Science | Medline30
Klerman GL, Weissman MM, Rounsaville BJ, Chevron ES. Interpersonal psychotherapy of depression. New York: Basic Books, 1984.
31
Beck AT, Rush AJ, Shaw BG, Emery G. Cognitive therapy of depression. New York: Guilford Press, 1979.
32
Lewinsohn PM. A behavioral approach to depression. In: Friedman RJ, Katz MM, eds. The psychology of depression: contemporary theory and research. Washington, D.C.: Hemisphere Publishing, 1974:157-78.
33
Diagnostic and statistical manual of mental disorders, 4th ed.: DSM-IV. Washington, D.C.: American Psychiatric Association, 1994.
34
First MB, Spitzer RL, Gibbon M, et al. Structured clinical interview for Axis-I DSM-IV disorders: patient edition (SCID-II, version 2.0). New York: New York State Psychiatric Institute Biometrics Research Department, 1994.
35
Hamilton M . Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967;6:278-296
CrossRef | Medline36
Fawcett J ,Epstein P ,Fiester SJ ,Elkin I ,Autry JH . Clinical management -- imipramine/placebo administration manual: NIMH Treatment of Depression Collaboration Research Program. Psychopharmacol Bull 1987;23:309-324
Medline37
McCullough JP. Therapist manual for cognitive behavioral analysis system of psychotherapy. Richmond: Virginia Commonwealth University, 1995.
38
Rush AJ ,Koran LM ,Miller MB , et al. The treatment of chronic depression. 1. Study design and rationale for evaluating the comparative efficacy of sertraline and imipramine as acute, crossover, continuation, and maintenance phase therapies. J Clin Psychiatry 1998;59:589-597
CrossRef | Web of Science | Medline
- Citing Articles (324)
Citing Articles
1
Heather M. Foran, Dina Vivian, K. Daniel O’Leary, Daniel N. Klein, Barbara O. Rothbaum, Rachel Manber, Martin B. Keller, James H. Kocsis, Michael E. Thase, Madhukar H. Trivedi. (2012) Risk for Partner Victimization and Marital Dissatisfaction Among Chronically Depressed Patients. Journal of Family Violence
CrossRef2
Elena Tomba, Giovanni A. Fava. (2012) Treatment Selection in Depression: The Role of Clinical Judgment. Psychiatric Clinics of North America
CrossRef3
Michael Browning, Maud Grol, Verena Ly, Guy M Goodwin, Emily A Holmes, Catherine J Harmer. (2011) Using an Experimental Medicine Model to Explore Combination Effects of Pharmacological and Cognitive Interventions for Depression and Anxiety. Neuropsychopharmacology 36:13, 2689-2697
CrossRef4
Paul Crits-Christoph, Michelle G. Newman, Karl Rickels, Robert Gallop, Mary Beth Connolly Gibbons, Jessica L. Hamilton, Sarah Ring-Kurtz, Amy M. Pastva. (2011) Combined medication and cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders 25:8, 1087-1094
CrossRef5
Fredric N. Busch, Larry S. Sandberg. (2011) Combined Treatment of Depression. Psychiatric Clinics of North America
CrossRef6
Donna M. Sudak. (2011) Cognitive Behavioral Therapy for Depression. Psychiatric Clinics of North America
CrossRef7
Andres G. Martinez, Rodolfo Mendoza-Denton. (2011) The Prospect of Plasticity: Malleability Views of Group Differences and their Implications for Intellectual Achievement, Mental/Behavioral Health, and Public Policy. Social Issues and Policy Review 5:1, 137-159
CrossRef8
Chiueng-Yi Feng, Hsin Chu, Chiung-Hua Chen, Yu-Shiun Chang, Tsai-Hwei Chen, Yuan-Hwa Chou, Yue-Cune Chang, Kuei-Ru Chou RN PhD. (2011) The Effect of Cognitive Behavioral Group Therapy for Depression: A Meta-Analysis 2000-2010. Worldviews on Evidence-Based Nursingno-no
CrossRef9
Thomas C. Baghai, Pierre Blier, David S. Baldwin, Michael Bauer, Guy M. Goodwin, Kostas N. Fountoulakis, Siegfried Kasper, Brian E. Leonard, Ulrik F. Malt, Dan J. Stein, Marcio Versiani, Hans-Jürgen Möller. (2011) Executive summary of the report by the WPA section on pharmacopsychiatry on general and comparative efficacy and effectiveness of antidepressants in the acute treatment of depressive disorders. European Archives of Psychiatry and Clinical Neuroscience
CrossRef10
, Thomas C. Baghai, Pierre Blier, David S. Baldwin, Michael Bauer, Guy M. Goodwin, Kostas N. Fountoulakis, Siegfried Kasper, Brian E. Leonard, Ulrik F. Malt, Dan Stein, Marcio Versiani, Hans-Jürgen Möller. (2011) General and comparative efficacy and effectiveness of antidepressants in the acute treatment of depressive disorders: a report by the WPA section of pharmacopsychiatry. European Archives of Psychiatry and Clinical Neuroscience 261:S3, 207-245
CrossRef11
Jae-Min Kim, Robert Stewart, Kyung-Yeol Bae, Su-Jin Yang, Jin-Sang Yoon, Sung-Won Jung, Min-Soo Lee, Hyeon-Woo Yim, Tae-Youn Jun. (2011) Physical comorbidity and 12-week treatment outcomes in Korean patients with depressive disorders: The CRESCEND study. Journal of Psychosomatic Research 71:5, 311-318
CrossRef12
E. Schramm, M. Berger. (2011) Differenzielle Indikation für Psychotherapie am Beispiel der Depression. Der Nervenarzt 82:11, 1414-1424
CrossRef13
B. Koekkoek, B. van Meijel, A. Schene, A. Smit, A. Kaasenbrood, G. Hutschemaekers. (2011) Interpersonal Community Psychiatric Treatment for non-psychotic chronic patients and nurses in outpatient mental health care: A controlled pilot study on feasibility and effects. International Journal of Nursing Studies
CrossRef14
Laura J. Thomas, Anna Abel, Nicola Ridgway, Tim Peters, David Kessler, Sandra Hollinghurst, Katrina Turner, Anne Garland, Bill Jerrom, Jill Morrison, Chris Williams, John Campbell, Willem Kuyken, Glyn Lewis, Nicola Wiles. (2011) Cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment resistant depression in primary care: The CoBalT randomised controlled trial protocol. Contemporary Clinical Trials
CrossRef15
H.-J. Möller, I. Bitter, J. Bobes, K. Fountoulakis, C. Höschl, S. Kasper. (2011) Position statement of the European Psychiatric Association (EPA) on the value of antidepressants in the treatment of unipolar depression. European Psychiatry
CrossRef16
S Susan Hedayati, Venkata Yalamanchili, Fredric O Finkelstein. (2011) A practical approach to the treatment of depression in patients with chronic kidney disease and end-stage renal disease. Kidney International
CrossRef17
Pia Ley, Sylvia Helbig-Lang, Sarah Czilwik, Thomas Lang, Andrew Worlitz, Klaus Brücher, Franz Petermann. (2011) Phenomenological differences between acute and chronic forms of major depression in inpatients. Nordic Journal of Psychiatry 65:5, 330-337
CrossRef18
Michael E. Thase. (2011) The Small Specific Effects of Antidepressants in Clinical Trials: What Do They Mean to Psychiatrists?. Current Psychiatry Reports
CrossRef19
Ritu Salani, Barbara L. Andersen. (2011) Gynecologic care for breast cancer survivors: Assisting in the transition to wellness. American Journal of Obstetrics and Gynecology
CrossRef20
Beatriz Rodríguez Vega, Pablo Orgaz Barnier, Carmen Bayón, Ángela Palao, Guadalupe Torres, Ana Hospital, Guillermo Benito, Maria Dieguez, Alberto Fernández Liria. (2011) Differences in depressed oncologic patients' narratives after receiving two different therapeutic interventions for depression: a qualitative study. Psycho-Oncologyn/a-n/a
CrossRef21
Babak Roshanaei-Moghaddam, Michael C. Pauly, David C. Atkins, Scott A. Baldwin, Murray B. Stein, Peter Roy-Byrne. (2011) Relative effects of CBT and pharmacotherapy in depression versus anxiety: is medication somewhat better for depression, and CBT somewhat better for anxiety?. Depression and Anxiety 28:7, 560-567
CrossRef22
Svetlana Oestergaard, Claus Møldrup. (2011) Optimal duration of combined psychotherapy and pharmacotherapy for patients with moderate and severe depression: A meta-analysis. Journal of Affective Disorders 131:1-3, 24-36
CrossRef23
S. Oestergaard, C. Møldrup. (2011) Improving outcomes for patients with depression by enhancing antidepressant therapy with non-pharmacological interventions: A systematic review of reviews. Public Health 125:6, 357-367
CrossRef24
Ranak B. Trivedi, Jason A. Nieuwsma, John W. Williams. (2011) Examination of the Utility of Psychotherapy for Patients with Treatment Resistant Depression: A Systematic Review. Journal of General Internal Medicine 26:6, 643-650
CrossRef25
Lisa S. Meredith, Robert B. Branstrom, Francisca Azocar, Ruth Fikes, Susan L. Ettner. (2011) A Collaborative Approach to Identifying Effective Incentives for Mental Health Clinicians to Improve Depression Care in a Large Managed Behavioral Healthcare Organization. Administration and Policy in Mental Health and Mental Health Services Research 38:3, 193-202
CrossRef26
2011. References. , 209-234.
CrossRef27
I. Zobel, S. Kech, D. van Calker, P. Dykierek, M. Berger, R. Schneibel, E. Schramm. (2011) Long-term effect of combined interpersonal psychotherapy and pharmacotherapy in a randomized trial of depressed patients. Acta Psychiatrica Scandinavica 123:4, 276-282
CrossRef28
Gregor Hasler. (2011) Can the neuroeconomics revolution revolutionize psychiatry?. Neuroscience & Biobehavioral Reviews
CrossRef29
Christopher G. Beevers. 2011. Appendix A: Research Providing the Evidence Base for the Interventions in This Volume. , 249-256.
CrossRef30
James P. McCullough, J. Kim Penberthy. 2011. Cognitive Behavioral Analysis System of Psychotherapy for Chronic Depression. , 183-220.
CrossRef31
Glen I. Spielmans, Margit I. Berman, Ashley N. Usitalo. (2011) Psychotherapy Versus Second-Generation Antidepressants in the Treatment of Depression. The Journal of Nervous and Mental Disease 199:3, 142-149
CrossRef32
Henricus G. Ruhé, Geeske van Rooijen, Jan Spijker, Frenk P.M.L. Peeters, Aart H. Schene. (2011) Staging methods for treatment resistant depression. A systematic review. Journal of Affective Disorders
CrossRef33
Jae-Min Kim, Seon-Young Kim, Robert Stewart, Joon-An Yoo, Kyung-Yeol Bae, Sung-Won Jung, Min-Soo Lee, Hyeon-Woo Yim, Tae-Youn Jun. (2011) Improvement within 2weeks and later treatment outcomes in patients with depressive disorders: The CRESCEND study. Journal of Affective Disorders 129:1-3, 183-190
CrossRef34
Elisabeth Schramm, Ingo Zobel, Petra Dykierek, Sabine Kech, Eva-Lotta Brakemeier, Anne Külz, Mathias Berger. (2011) Cognitive behavioral analysis system of psychotherapy versus interpersonal psychotherapy for early-onset chronic depression: A randomized pilot study. Journal of Affective Disorders 129:1-3, 109-116
CrossRef35
J. Guidi, G. A. Fava, M. Fava, G. I. Papakostas. (2011) Efficacy of the sequential integration of psychotherapy and pharmacotherapy in major depressive disorder: a preliminary meta-analysis. Psychological Medicine 41:02, 321-331
CrossRef36
Eva-Lotta Brakemeier, Vera Engel, Elisabeth Schramm, Ingo Zobel, Teresa Schmidt, Martin Hautzinger, Mathias Berger, Claus Normann. (2011) Feasibility and Outcome of Cognitive Behavioral Analysis System of Psychotherapy (CBASP) for Chronically Depressed Inpatients: A Pilot Study. Psychotherapy and Psychosomatics 80:3, 191-194
CrossRef37
Elisabeth Schramm, Martin Hautzinger, Ingo Zobel, Levente Kriston, Mathias Berger, Martin Härter. (2011) Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial. BMC Psychiatry 11:1, 134
CrossRef38
Jae-Min Kim, Sung-Wan Kim, Robert Stewart, Seon-Young Kim, Jin-Sang Yoon, Sung-Won Jung, Min-Soo Lee, Hyeon-Woo Yim, Tae-Youn Jun. (2011) Predictors of 12-week remission in a nationwide cohort of people with depressive disorders: the CRESCEND study. Human Psychopharmacology: Clinical and Experimental 26:1, 41-50
CrossRef39
Douglas A Drossman. (2011) Abuse, Trauma, and GI Illness: Is There a Link?. The American Journal of Gastroenterology 106:1, 14-25
CrossRef40
Junko Ishizaki, Masaru Mimura. (2011) Dysthymia and Apathy: Diagnosis and Treatment. Depression Research and Treatment 2011, 1-7
CrossRef41
Paul E. Holtzheimer, Helen S. Mayberg. (2011) Stuck in a rut: rethinking depression and its treatment. Trends in Neurosciences 34:1, 1-9
CrossRef42
Desirée Spronk, Martijn Arns, Paul B. Fitzgerald. 2011. Repetitive Transcranial Magnetic Stimulation in DepressionProtocols, Mechanisms, and New Developments. , 257-291.
CrossRef43
Martijn Arns, Jay Gunkelman, Sebastian Olbrich, Christian Sander, Ulrich Hegerl. 2011. EEG Vigilance and Phenotypes in NeuropsychiatryImplications for Intervention. , 79-435.
CrossRef44
Tanja Kuhnen, Franziska Knappke, Tanja Otto, Stephanie Friedrich, Jan P Klein, Kai G Kahl, Michael Huppe, Valerija Sipos, Ulrich Schweiger. (2011) Chronic Depression: Development and Evaluation of the Luebeck Questionnaire for Recording Preoperational Thinking (LQPT). BMC Psychiatry 11:1, 199
CrossRef45
M. Adida, R. Richieri, M. Maurel, A. Kaladjian, D. Da Fonseca, T. Bottai, E. Fakra, D. Pringuey, J.-M. Azorin. (2010) Troubles affectifs, antipsychotiques et thymorégulateurs : innovations thérapeutiques. L'Encéphale 36, S188-S196
CrossRef46
David Veale, Anna Stout. (2010) Cognitive behaviour therapy meets psychopharmacotherapy. The Cognitive Behaviour Therapist 3:04, 117-131
CrossRef47
Christine Heim, Margaret Shugart, W. Edward Craighead, Charles B. Nemeroff. (2010) Neurobiological and psychiatric consequences of child abuse and neglect. Developmental Psychobiology 52:7, 671-690
CrossRef48
Paula Freitas Ramalho da Silva, Sergio Luis Blay. (2010) Prevalence and Characteristics of Outpatient Psychotherapy Use. The Journal of Nervous and Mental Disease 198:11, 783-789
CrossRef49
Steven D. Hollon, Kathryn Ponniah. (2010) A review of empirically supported psychological therapies for mood disorders in adults. Depression and Anxiety 27:10, 891-932
CrossRef50
Vivien Hunot, Theresa HM Moore, Deborah Caldwell, Philippa Davies, Hannah Jones, Glyn Lewis, Rachel Churchill, Rachel Churchill. 2010. Interpersonal, cognitive analytic and other integrative therapies versus other psychological therapies for depression. .
CrossRef51
Rachel Churchill, Philippa Davies, Deborah Caldwell, Theresa HM Moore, Hannah Jones, Glyn Lewis, Vivien Hunot, Rachel Churchill. 2010. Interpersonal, cognitive analytic and other integrative therapies versus treatment as usual for depression. .
CrossRef52
Ellen Driessen, Steven D. Hollon. (2010) Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators. Psychiatric Clinics of North America 33:3, 537-555
CrossRef53
K.A. Ganasen, J.C. Ipser, D.J. Stein. (2010) Augmentation of Cognitive Behavioral Therapy with Pharmacotherapy. Psychiatric Clinics of North America 33:3, 687-699
CrossRef54
Ingo Zobel, Doris Werden, Hans Linster, Petra Dykierek, Tobias Drieling, Mathias Berger, Elisabeth Schramm. (2010) Theory of mind deficits in chronically depressed patients. Depression and Anxiety 27:9, 821-828
CrossRef55
Anna Ivanova, Danit Nitka, Norbert Schmitz. (2010) Epidemiology of antidepressant medication use in the Canadian diabetes population. Social Psychiatry and Psychiatric Epidemiology 45:9, 911-919
CrossRef56
Taoufik Alsaadi. (2010) Neuropsychiatric issues in patients with epilepsy: focus on depression. Therapy 7:5, 507-515
CrossRef57
Gregor Wilbertz, Eva-Lotta Brakemeier, Ingo Zobel, Martin Härter, Elisabeth Schramm. (2010) Exploring preoperational features in chronic depression. Journal of Affective Disorders 124:3, 262-269
CrossRef58
Robin B. Jarrett, Michael E. Thase. (2010) Comparative efficacy and durability of continuation phase cognitive therapy for preventing recurrent depression: Design of a double-blinded, fluoxetine- and pill placebo-controlled, randomized trial with 2-year follow-up. Contemporary Clinical Trials 31:4, 355-377
CrossRef59
Greg Murray, Erin E. Michalak, Auby Axler, David Yaxley, Brenda Hayashi, Åsa Westrin, John S. Ogrodniczuk, Edwin M. Tam, Lakshmi N. Yatham, Raymond W. Lam. (2010) Relief of Chronic or Resistant Depression (Re-ChORD): A pragmatic, randomized, open-treatment trial of an integrative program intervention for chronic depression. Journal of Affective Disorders 123:1-3, 243-248
CrossRef60
Giovanni A. Fava, Elena Tomba. (2010) New Modalities of Assessment and Treatment Planning in Depression. CNS Drugs 24:6, 453-465
CrossRef61
Daniela D. Pollak, Carlos E. Rey, Francisco J. Monje. (2010) Rodent models in depression research: Classical strategies and new directions. Annals of Medicine 42:4, 252-264
CrossRef62
Christian Klesse, Mathias Berger, Isaac Bermejo, Tom Bschor, Jochen Gensichen, Timo Harfst, Martin Hautzinger, Carsten Kolada, Christine Kühner, Jürgen Matzat, Christoph Mundt, Wilhelm Niebling, Rainer Richter, Henning Schauenburg, Holger Schulz, Frank Schneider, Martin Härter. (2010) Evidenzbasierte Psychotherapie der Depression. Psychotherapeut 55:3, 247-263
CrossRef63
Jami F. Young, Laura Mufson, Robert Gallop. (2010) Preventing depression: a randomized trial of interpersonal psychotherapy-adolescent skills training. Depression and Anxiety 27:5, 426-433
CrossRef64
Eero Castrén, Tomi Rantamäki. (2010) The role of BDNF and its receptors in depression and antidepressant drug action: Reactivation of developmental plasticity. Developmental Neurobiology 70:5, 289-297
CrossRef65
W. H. Denton, T. J. Carmody, A. J. Rush, M. E. Thase, M. H. Trivedi, B. A. Arnow, D. N. Klein, M. B. Keller. (2010) Dyadic discord at baseline is associated with lack of remission in the acute treatment of chronic depression. Psychological Medicine 40:03, 415
CrossRef66
Cara C. Lewis, Anne D. Simons, Lananh J. Nguyen, Jessica L. Murakami, Mark W. Reid, Susan G. Silva, John S. March. (2010) Impact of Childhood Trauma on Treatment Outcome in the Treatment for Adolescents with Depression Study (TADS). Journal of the American Academy of Child & Adolescent Psychiatry 49:2, 132-140
CrossRef67
Richard C. Shelton, Olawale Osuntokun, Alexandra N. Heinloth, Sara A. Corya. (2010) Therapeutic Options for Treatment-Resistant Depression. CNS Drugs 24:2, 131-161
CrossRef68
Lata K. McGinn, William C. Sanderson, Jennifer Steinberg. 2010. Psychotherapy, Efficacy of. .
CrossRef69
Daniel N. Klein. 2010. Dysthymic Disorder. .
CrossRef70
James P. McCullough. 2010. Cognitive Behavioral Analysis System of Psychotherapy. .
CrossRef71
Ellen M. Walker, David C. Steffens. (2010) Understanding Depression and Cognitive Impairment in the Elderly. Psychiatric Annals 40:1, 29-40
CrossRef72
Stanley E. Althof. (2010) What's New in Sex Therapy (CME). Journal of Sexual Medicine 7:1pt1, 5-13
CrossRef73
Tom Bschor. (2010) Therapy-resistant depression. Expert Review of Neurotherapeutics 10:1, 77-86
CrossRef74
Christine E. Ryan, G.I. Keitner, S. Bishop. (2010) An adjunctive Management of Depression Program for difficult-to-treat depressed patients and their families. Depression and Anxiety 27:1, 27-34
CrossRef75
Douglas A Drossman. (2009) Beyond Tricyclics: New Ideas for Treating Patients With Painful and Refractory Functional Gastrointestinal Symptoms. The American Journal of Gastroenterology 104:12, 2897-2902
CrossRef76
James F. Malec. (2009) Ethical and evidence-based practice in brain injury rehabilitation. Neuropsychological Rehabilitation 19:6, 790-806
CrossRef77
Warren W. Tryon. (2009) Cognitive Processes in Cognitive and Pharmacological Therapies. Cognitive Therapy and Research 33:6, 570-584
CrossRef78
Wolfgang Lutz, Niklaus Stulz, Katharina Köck. (2009) Patterns of early change and their relationship to outcome and follow-up among patients with major depressive disorders. Journal of Affective Disorders 118:1-3, 60-68
CrossRef79
Henrik Walter, Mathias Berger, Knut Schnell. (2009) Neuropsychotherapy: conceptual, empirical and neuroethical issues. European Archives of Psychiatry and Clinical Neuroscience 259:S2, 173-182
CrossRef80
Sagar V. Parikh, Zindel V. Segal, Sophie Grigoriadis, Arun V. Ravindran, Sidney H. Kennedy, Raymond W. Lam, Scott B. Patten. (2009) Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults. II. Psychotherapy alone or in combination with antidepressant medication. Journal of Affective Disorders 117, S15-S25
CrossRef81
Rachel E. Maddux, Lawrence P. Riso, Daniel N. Klein, John C. Markowitz, Barbara O. Rothbaum, Bruce A. Arnow, Rachel Manber, Janice A. Blalock, Gabor I. Keitner, Michael E. Thase. (2009) Select comorbid personality disorders and the treatment of chronic depression with nefazodone, targeted psychotherapy, or their combination. Journal of Affective Disorders 117:3, 174-179
CrossRef82
S. Susan Hedayati, Fredric O. Finkelstein. (2009) Epidemiology, Diagnosis, and Management of Depression in Patients With CKD. American Journal of Kidney Diseases 54:4, 741-752
CrossRef83
Pia Ley, Sylvia Helbig-Lang, Franz Petermann. (2009) Kann man chronische Depression effektiv psychotherapeutisch behandeln?. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie 57:4, 253-263
CrossRef84
Katrin Wambach, Winfried Rief. (2009) Praktische Erfahrungen mit dem Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Zeitschrift für Psychiatrie, Psychologie und Psychotherapie 57:4, 277-284
CrossRef85
Michael E. Thase, Aaron M. Koenig. 2009. Outcomes in the Treatment of Major Depressive Disorder. , 22-53.
CrossRef86
Brian Johnson. 2009. Depression and Addiction. , 220-233.
CrossRef87
John H. Krystal, David F. Tolin, Gerard Sanacora, Stacy A. Castner, Graham V. Williams, Deane E. Aikins, Ralph E. Hoffman, D. Cyril D'Souza. (2009) Neuroplasticity as a target for the pharmacotherapy of anxiety disorders, mood disorders, and schizophrenia. Drug Discovery Today 14:13-14, 690-697
CrossRef88
Benji T Kurian, Tracy L Greer, Madhukar H Trivedi. (2009) Strategies to enhance the therapeutic efficacy of antidepressants: targeting residual symptoms. Expert Review of Neurotherapeutics 9:7, 975-984
CrossRef89
Robert Gallop, Giorgio A. Tasca. (2009) Multilevel modeling of longitudinal data for psychotherapy researchers: II. The complexities. Psychotherapy Research 19:4-5, 438-452
CrossRef90
Paul Gilbert, Kirsten McEwan, Rebecca Bellew, Alison Mills, Corinne Gale. (2009) The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm. Psychology and Psychotherapy: Theory, Research and Practice 82:2, 123-136
CrossRef91
M. Berger, E.L. Brakemeier, C. Klesse, E. Schramm. (2009) Depressive Störungen. Der Nervenarzt 80:5, 540-555
CrossRef92
Thorsten Barnhofer, Catherine Crane, Emily Hargus, Myanthi Amarasinghe, Rosie Winder, J. Mark G. Williams. (2009) Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study. Behaviour Research and Therapy 47:5, 366-373
CrossRef93
G. S. Malhi, D. Adams, R. Porter, A. Wignall, L. Lampe, N. O’Connor, M. Paton, L. A. Newton, G. Walter, A. Taylor, M. Berk, R. T. Mulder. (2009) Clinical practice recommendations for depression. Acta Psychiatrica Scandinavica 119, 8-26
CrossRef94
P. de Jonge, F. B. Hadj, D. Boffa, C. Zdrojewski, Y. Dorogi, A. So, J. Ruiz, F. Stiefel. (2009) Prevention of Major Depression in Complex Medically Ill Patients: Preliminary Results From a Randomized, Controlled Trial. Psychosomatics 50:3, 227-233
CrossRef95
Kelly C. Cukrowicz, Phillip N. Smith, Holly C. Hohmeister, Thomas E. Joiner. (2009) The moderation of an early intervention program for anxiety and depression by specific psychological symptoms. Journal of Clinical Psychology 65:4, 337-351
CrossRef96
Lydia Falconnier. (2009) Socioeconomic Status in the Treatment of Depression. American Journal of Orthopsychiatry 79:2, 148-158
CrossRef97
Dietrich van Calker, Ingo Zobel, Petra Dykierek, Christoph Michael Deimel, Sabine Kech, Klaus Lieb, Mathias Berger, Elisabeth Schramm. (2009) Time course of response to antidepressants: Predictive value of early improvement and effect of additional psychotherapy. Journal of Affective Disorders 114:1-3, 243-253
CrossRef98
David V. Sheehan, Charles B. Nemeroff, Michael E. Thase, Richard Entsuah. (2009) Placebo-controlled inpatient comparison of venlafaxine and fluoxetine for the treatment of major depression with melancholic features. International Clinical Psychopharmacology 24:2, 61-86
CrossRef99
Edward S. Friedman, Michael E. Thase, Stephen R. Wisniewski, Madhukar H. Trivedi, Melanie M. Biggs, Maurizio Fava, Diane Warden, George Niederehe, James F. Luther, A. John Rush. (2009) Cognitive Therapy Augmentation versus CT Switch Treatment: A STAR*D Report. International Journal of Cognitive Therapy 2:1, 66-87
CrossRef100
J. W. Pettit, P. M. Lewinsohn, R. E. Roberts, J. R. Seeley, L. Monteith. (2009) The long-term course of depression: development of an empirical index and identification of early adult outcomes. Psychological Medicine 39:03, 403
CrossRef101
Pim Cuijpers, Annemieke van Straten, Lisanne Warmerdam, Gerhard Andersson. (2009) Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis. Depression and Anxiety 26:3, 279-288
CrossRef102
Mitsuhiro Sado, Martin Knapp, Keita Yamauchi, Daisuke Fujisawa, Mirai So, Atsuo Nakagawa, Toshiaki Kikuchi, Yutaka Ono. (2009) Cost-effectiveness of combination therapy versus antidepressant therapy for management of depression in Japan. Australian and New Zealand Journal of Psychiatry 43:6, 539-547
CrossRef103
Jacques P. Barber. (2009) Toward a working through of some core conflicts in psychotherapy research. Psychotherapy Research 19:1, 1-12
CrossRef104
Benedetto Vitiello. (2009) Combined Cognitive-Behavioural Therapy and Pharmacotherapy for Adolescent Depression. CNS Drugs 23:4, 271-280
CrossRef105
A. Hull, J. Swan, R. McVicar. (2009) W03-01 Treating chronic depression with cognitive behavioural analysis system of psychotherapy(CBASP). European Psychiatry 24, S22
CrossRef106
Paola Pedrelli, Greg C. Feldman, Sienna Vorono, Maurizio Fava, Timothy Petersen. (2008) Dysfunctional attitudes and perceived stress predict depressive symptoms severity following antidepressant treatment in patients with chronic depression. Psychiatry Research 161:3, 302-308
CrossRef107
Daniela Z. Knijnik, Carlos Blanco, Giovanni Abrahão Salum, Carolina U. Moraes, Clarissa Mombach, Ellen Almeida, Marília Pereira, Atahualpa Strapasson, Gisele G. Manfro, Cláudio L. Eizirik. (2008) A pilot study of clonazepam versus psychodynamic group therapy plus clonazepam in the treatment of generalized social anxiety disorder. European Psychiatry 23:8, 567-574
CrossRef108
S Nassir Ghaemi. (2008) Why antidepressants are not antidepressants: STEP-BD, STAR*D, and the return of neurotic depression. Bipolar Disorders 10:8, 957-968
CrossRef109
Dana C. Torpey, Daniel N. Klein. (2008) Chronic depression: Update on classification and treatment. Current Psychiatry Reports 10:6, 458-464
CrossRef110
E. Kaltenthaler, P. Sutcliffe, G. Parry, C. Beverley, A. Rees, M. Ferriter. (2008) The acceptability to patients of computerized cognitive behaviour therapy for depression: a systematic review. Psychological Medicine 38:11, 1521
CrossRef111
Thomas D. Meyer, Jan Scott. (2008) Cognitive Behavioural Therapy for Mood Disorders. Behavioural and Cognitive Psychotherapy 36:06, 685
CrossRef112
Eleanor L Olvey, Grant H Skrepnek. (2008) The cost-effectiveness of sertraline in the treatment of depression. Expert Opinion on Pharmacotherapy 9:14, 2497-2508
CrossRef113
Zac E. Imel, Melanie B. Malterer, Kevin M. McKay, Bruce E. Wampold. (2008) A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia. Journal of Affective Disorders 110:3, 197-206
CrossRef114
James H. Kocsis, Alan J. Gelenberg, Barbara Rothbaum, Daniel N. Klein, Madhukar H. Trivedi, Rachel Manber, Martin B. Keller, Robert Howland, Michael E. Thase. (2008) Chronic forms of major depression are still undertreated in the 21st century: Systematic assessment of 801 patients presenting for treatment. Journal of Affective Disorders 110:1-2, 55-61
CrossRef115
David C. Mohr, Lea Vella, Stacey Hart, Timothy Heckman, Gregory Simon. (2008) The Effect of Telephone-Administered Psychotherapy on Symptoms of Depression and Attrition: A Meta-Analysis. Clinical Psychology: Science and Practice 15:3, 243-253
CrossRef116
Saskia de Maat, Jack Dekker, Robert Schoevers, Gerda van Aalst, Cecile Gijsbers-van Wijk, Marielle Hendriksen, Simone Kool, Jaap Peen, Rien Van, Frans de Jonghe. (2008) Short Psychodynamic Supportive Psychotherapy, antidepressants, and their combination in the treatment of major depression: a mega-analysis based on three Randomized Clinical Trials. Depression and Anxiety 25:7, 565-574
CrossRef117
Elisabeth Schramm, Daniel Schneider, Ingo Zobel, Dietrich van Calker, Petra Dykierek, Sabine Kech, Martin Härter, Mathias Berger. (2008) Efficacy of Interpersonal Psychotherapy plus pharmacotherapy in chronically depressed inpatients. Journal of Affective Disorders 109:1-2, 65-73
CrossRef118
Susan D. Raffa, Jill A. Stoddard, Kamila S. White, David H. Barlow, Jack M. Gorman, M Katherine Shear, Scott W. Woods. (2008) Relapse Following Combined Treatment Discontinuation in a Placebo-Controlled Trial for Panic Disorder. The Journal of Nervous and Mental Disease 196:7, 548-555
CrossRef119
John J. Barry, Alan B. Ettinger, Peggy Friel, Frank G. Gilliam, Cynthia L. Harden, Bruce Hermann, Andres M. Kanner, Rochelle Caplan, Sigita Plioplys, Jay Salpekar, David Dunn, Joan Austin, Jana Jones. (2008) Consensus statement: The evaluation and treatment of people with epilepsy and affective disorders. Epilepsy & Behavior 13, S1-S29
CrossRef120
Bauke Koekkoek, Berno van Meijel, Aart Schene, Giel Hutschemaekers. (2008) Clinical problems in the long-term care of patients with chronic depression. Journal of Advanced Nursing 62:6, 689-697
CrossRef121
2008. References. , 397-405.
CrossRef122
Pamela H. Mitchell, Linda Teri, Richard Veith, Ann Buzaitis, David Tirschwell, Kyra Becker, Michael Fruin, Ruth Kohen, Kevin C. Cain. (2008) Living Well with Stroke: Design and Methods for a Randomized Controlled Trial of a Psychosocial Behavioral Intervention for Poststroke Depression. Journal of Stroke and Cerebrovascular Diseases 17:3, 109-115
CrossRef123
Thomas E. Joiner, Scharles Petty, Marisol Perez, Natalie Sachs-Ericsson, M. David Rudd. (2008) Depressive symptoms induce paranoid symptoms in narcissistic personalities (but not narcissistic symptoms in paranoid personalities). Psychiatry Research 159:1-2, 237-244
CrossRef124
Janice A. Blalock, Rachel T. Fouladi, Paul M. Cinciripini, John C. Markowitz, Daniel N. Klein, Barbara O. Rothbaum, Bruce A. Arnow, Rachel Manber, Lawrence P. Riso, Dawen Sui, James P. McCullough. (2008) Cognitive and Behavioral Mediators of Combined Pharmacotherapy and Psychotherapy of Chronic Depression. Cognitive Therapy and Research 32:2, 197-211
CrossRef125
John C. Markowitz. (2008) Evidence-Based Psychotherapies for Depression. Journal of Occupational and Environmental Medicine 50:4, 437-440
CrossRef126
Martin Hautzinger. (2008) Psychotherapie der Depression. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 51:4, 422-429
CrossRef127
George A. Hurst, Marion G. Williams, Judith E. King, Richard Viken. (2008) Faith-Based Intervention in Depression, Anxiety, and Other Mental Disturbances. Southern Medical Journal 101:4, 388-392
CrossRef128
Jesse R. Fann, Anne M. Thomas-Rich, Wayne J. Katon, Deborah Cowley, Mary Pepping, Bonnie A. McGregor, Julie Gralow. (2008) Major depression after breast cancer: a review of epidemiology and treatment. General Hospital Psychiatry 30:2, 112-126
CrossRef129
Anthony D. Roth, Stephen Pilling. (2008) Using an Evidence-Based Methodology to Identify the Competences Required to Deliver Effective Cognitive and Behavioural Therapy for Depression and Anxiety Disorders. Behavioural and Cognitive Psychotherapy 36:02,
CrossRef130
Lars-Göran Öst. (2008) Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy 46:3, 296-321
CrossRef131
D. C. Steffens, G. G. Potter. (2008) Geriatric depression and cognitive impairment. Psychological Medicine 38:02,
CrossRef132
Matthias Backenstrass, Christoph Mundt. 2008. Affektive Störungen. , 371-411.
CrossRef133
Chanaka Wijeratne, Perminder Sachdev. (2008) Treatment-resistant depression: critique of current approaches. Australian and New Zealand Journal of Psychiatry 42:9, 751-762
CrossRef134
Nicola J Wiles, Sandra Hollinghurst, Victoria Mason, Meyrem Musa, Victoria Burt, Julia Hyde, Bill Jerrom, Glyn Lewis, David Kessler. (2008) A Randomized Controlled Trial of Cognitive Behavioural Therapy as an Adjunct to Pharmacotherapy in Primary Care Based Patients with Treatment Resistant Depression: A Pilot Study. Behavioural and Cognitive Psychotherapy 36:01,
CrossRef135
Roseanne DeFronzo Dobkin, Matthew Menza, Karina L Bienfait. (2008) CBT for the treatment of depression in Parkinson’s disease: a promising nonpharmacological approach. Expert Review of Neurotherapeutics 8:1, 27-35
CrossRef136
J.C. Markowitz. (2008) A Comparison of Medication Side Effect Reports by Panic Disorder Patients With and Without Concomitant Cognitive Behavior Therapy. Yearbook of Psychiatry and Applied Mental Health 2008, 59-61
CrossRef137
Henricus L. Van, Robert A. Schoevers, Simone Kool, Mariëlle Hendriksen, Jaap Peen, Jack Dekker. (2008) Does early response predict outcome in psychotherapy and combined therapy for major depression?. Journal of Affective Disorders 105:1-3, 261-265
CrossRef138
2008. bibliographie. , 163-177.
CrossRef139
Marc B.J. Blom, Philip Spinhoven, Tonko Hoffman, Kosse Jonker, Erik Hoencamp, P.M. Judith Haffmans, Richard van Dyck. (2007) Severity and duration of depression, not personality factors, predict short term outcome in the treatment of major depression. Journal of Affective Disorders 104:1-3, 119-126
CrossRef140
Diane Warden, A. John Rush, Madhukar H. Trivedi, Maurizio Fava, Stephen R. Wisniewski. (2007) The STAR*D project results: A comprehensive review of findings. Current Psychiatry Reports 9:6, 449-459
CrossRef141
Unützer, Jürgen, . (2007) Late-Life Depression. New England Journal of Medicine 357:22, 2269-2276
Full Text142
Jeanne Leventhal Alexander, Lorraine Dennerstein, Nancy Fugate Woods, Bruce S McEwen, Uriel Halbreich, Krista Kotz, Gregg Richardson. (2007) Role of stressful life events and menopausal stage in wellbeing and health. Expert Review of Neurotherapeutics 7:11s, S93-S113
CrossRef143
Jeanne Leventhal Alexander, Gregg Richardson, Lydia Grypma, Enid M Hunkeler. (2007) Collaborative depression care, screening, diagnosis and specificity of depression treatments in the primary care setting. Expert Review of Neurotherapeutics 7:11s, S59-S80
CrossRef144
(2007) Practice Parameter for the Assessment and Treatment of Children and Adolescents With Depressive Disorders. Journal of the American Academy of Child & Adolescent Psychiatry 46:11, 1503-1526
CrossRef145
Rachel E. Maddux, Lawrence P. Riso. (2007) Promoting the Scientist–practitioner Mindset in Clinical Training. Journal of Contemporary Psychotherapy 37:4, 213-220
CrossRef146
Kelly C. Cukrowicz, Thomas E. Joiner. (2007) Computer-Based Intervention for Anxious and Depressive Symptoms in a Non-Clinical Population. Cognitive Therapy and Research 31:5, 677-693
CrossRef147
U. Schweiger, V. Sipos, S. Rudolf, S. Steinlechner, F. Hohagen. (2007) Psychotherapie bei chronischer Depression. Der Nervenarzt 78:S3, 565-574
CrossRef148
Thomas E. Joiner, Joan M. Cook, Michel Hersen, Kathryn H. Gordon. (2007) Double depression in older adult psychiatric outpatients: Hopelessness as a defining feature. Journal of Affective Disorders 101:1-3, 235-238
CrossRef149
Jean-Philippe Laurenceau, Adele M. Hayes, Greg C. Feldman. (2007) Some methodological and statistical issues in the study of change processes in psychotherapy. Clinical Psychology Review 27:6, 682-695
CrossRef150
Johan Schubert. (2007) Psychotherapy and antidepressant medication: Scope, procedure and interaction: A survey of psychotherapists’ experience. European Journal of Psychotherapy & Counselling 9:2, 191-207
CrossRef151
Patrick Luyten, Sidney J. Blatt. (2007) Looking Back Towards the Future: Is It Time to Change the DSM Approach to Psychiatric Disorders? The Case of Depression. Psychiatry: Interpersonal & Biological Processes 70:2, 85-99
CrossRef152
Scott R. Braithwaite, Frank D. Fincham. (2007) ePREP: Computer Based Prevention of Relationship Dysfunction, Depression and Anxiety. Journal of Social and Clinical Psychology 26:5, 609-622
CrossRef153
Charles F. Gillespie, Charles B. Nemeroff. (2007) Corticotropin-Releasing Factor and the Psychobiology of Early-Life Stress. Current Directions in Psychological Science 16:2, 85-89
CrossRef154
Charles B. Nemeroff. (2007) The burden of severe depression: A review of diagnostic challenges and treatment alternatives. Journal of Psychiatric Research 41:3-4, 189-206
CrossRef155
John W. Williams, Martha Gerrity, Tracey Holsinger, Steve Dobscha, Bradley Gaynes, Allen Dietrich. (2007) Systematic review of multifaceted interventions to improve depression care. General Hospital Psychiatry 29:2, 91-116
CrossRef156
Greg Feldman. (2007) Cognitive and Behavioral Therapies for Depression: Overview, New Directions, and Practical Recommendations for Dissemination. Psychiatric Clinics of North America 30:1, 39-50
CrossRef157
Gary Rodin, Nancy Lloyd, Mark Katz, Esther Green, Jean A. Mackay, Rebecca K. S. Wong, . (2007) The treatment of depression in cancer patients: a systematic review. Supportive Care in Cancer 15:2, 123-136
CrossRef158
Daniel le Grange, Katharine L. Loeb. (2007) Early identification and treatment of eating disorders: prodrome to syndrome. Early Intervention in Psychiatry 1:1, 27-39
CrossRef159
John Preston. (2007) Response to “Myths and the Missing Link” Paper by Sparks, Duncan, and Miller. Journal of Family Psychotherapy 17:3-4, 119-126
CrossRef160
Jacqueline A. Sparks, Barry L. Duncan, Scott D. Miller. (2007) Integrating Psychotherapy and Pharmacotherapy. Journal of Family Psychotherapy 17:3-4, 83-108
CrossRef161
Pieter J. Molenaar, Jack Dekker, Rien Van, Marielle Hendriksen, Aukje Vink, Robert A. Schoevers. (2007) Does adding psychotherapy to pharmacotherapy improve social functioning in the treatment of outpatient depression?. Depression and Anxiety 24:8, 553-562
CrossRef162
Saskia M. de Maat, Jack Dekker, Robert A. Schoevers, Frans de Jonghe. (2007) Relative efficacy of psychotherapy and combined therapy in the treatment of depression: A meta-analysis. European Psychiatry 22:1, 1-8
CrossRef163
Annette Schaub, Jana Kopinke, Anke Neusser, Marketa Charypar. (2007) Kognitiv-psychoedukative Gruppenintervention bei stationären Patienten mit depressiven Erkrankungen – Ergebnisse einer prospektiven Pilotstudie. Verhaltenstherapie 17:3, 167-173
CrossRef164
Bruce A. Arnow, Christine Blasey, Rachel Manber, Michael J. Constantino, John C. Markowitz, Daniel N. Klein, Michael E. Thase, James H. Kocsis, A. John Rush. (2007) Dropouts versus completers among chronically depressed outpatients. Journal of Affective Disorders 97:1-3, 197-202
CrossRef165
Marc B.J. Blom, Kosse Jonker, Elise Dusseldorp, Philip Spinhoven, Erik Hoencamp, Judith Haffmans, Richard van Dyck. (2007) Combination Treatment for Acute Depression Is Superior Only when Psychotherapy Is Added to Medication. Psychotherapy and Psychosomatics 76:5, 289-297
CrossRef166
Lawrence P. Riso, Shoshana E. Froman, Mona Raouf, Phillip Gable, Rachel E. Maddux, Noëlle Turini-Santorelli, Suzanne Penna, Jaime A. Blandino, Carli H. Jacobs, Melissa Cherry. (2006) The Long-Term Stability of Early Maladaptive Schemas. Cognitive Therapy and Research 30:4, 515-529
CrossRef167
J. Simon, S. Pilling, R. Burbeck, D. Goldberg. (2006) Treatment options in moderate and severe depression: decision analysis supporting a clinical guideline. The British Journal of Psychiatry 189:6, 494-501
CrossRef168
Marcia Kaplan, Sergio V. Delgado. (2006) When Worlds Converge: Combining Depth Psychotherapy and Psychotropic Medications. Bulletin of the Menninger Clinic 70:4, 253-272
CrossRef169
DAVID A. BRENT. (2006) Glad for What TADS Adds, but Many TADS Grads Still Sad. Journal of the American Academy of Child & Adolescent Psychiatry 45:12, 1461-1464
CrossRef170
BETSY KENNARD, SUSAN SILVA, BENEDETTO VITIELLO, JOHN CURRY, CHRISTOPHER KRATOCHVIL, ANNE SIMONS, JENNIFER HUGHES, NORAH FEENY, ELIZABETH WELLER, MICHAEL SWEENEY, MARK REINECKE, SANJEEV PATHAK, GOLDA GINSBURG, GRAHAM EMSLIE, JOHN MARCH. (2006) Remission and Residual Symptoms After Short-Term Treatment in the Treatment of Adolescents With Depression Study (TADS). Journal of the American Academy of Child & Adolescent Psychiatry 45:12, 1404-1411
CrossRef171
Paul E Holtzheimer, Charles B Nemeroff. (2006) Emerging treatments for depression. Expert Opinion on Pharmacotherapy 7:17, 2323-2339
CrossRef172
Patrick Luyten, Sidney J. Blatt, Boudewijn Van Houdenhove, Jozef Corveleyn. (2006) Depression research and treatment: Are we skating to where the puck is going to be?. Clinical Psychology Review 26:8, 985-999
CrossRef173
Giovanni A Fava, Seung K Park, Nicoletta Sonino. (2006) Treatment of recurrent depression. Expert Review of Neurotherapeutics 6:11, 1735-1740
CrossRef174
Suzanne Perraud, Kathleen R. Delaney, Linnea Carlson-Sabelli, Mary E. Johnson, Rebekah Shephard, Olimpia Paun. (2006) Advanced Practice Psychiatric Mental Health Nursing, Finding Our Core: The Therapeutic Relationship in 21st Century. Perspectives In Psychiatric Care 42:4, 215-226
CrossRef175
Gil Zalsman, David A. Brent, V. Robin Weersing. (2006) Depressive Disorders in Childhood and Adolescence: An Overview. Child and Adolescent Psychiatric Clinics of North America 15:4, 827-841
CrossRef176
David A. Brent, Boris Birmaher. (2006) Treatment-Resistant Depression in Adolescents: Recognition and Management. Child and Adolescent Psychiatric Clinics of North America 15:4, 1015-1034
CrossRef177
Steven M. Baskin, Gay L. Lipchik, Todd A. Smitherman. (2006) Mood and Anxiety Disorders in Chronic Headache. Headache: The Journal of Head and Face Pain 46:s3, S76-S87
CrossRef178
Saskia De Maat, Jack Dekker, Robert Schoevers, Frans De Jonghe. (2006) Relative efficacy of psychotherapy and pharmacotherapy in the treatment of depression: A meta-analysis. Psychotherapy Research 16:5, 566-578
CrossRef179
Lisa A. Uebelacker, Philip S. Wang, Patricia Berglund, Ronald C. Kessler. (2006) Clinical differences among patients treated for mental health problems in general medical and specialty mental health settings in the National Comorbidity Survey Replication. General Hospital Psychiatry 28:5, 387-395
CrossRef180
Nadia E. Stellrecht, Thomas E. Joiner Jr., M. David Rudd. (2006) Responding to and treating negative interpersonal processes in suicidal depression. Journal of Clinical Psychology 62:9, 1129-1140
CrossRef181
A John Rush, Helena C Kraemer, Harold A Sackeim, Maurizio Fava, Madhukar H Trivedi, Ellen Frank, Philip T Ninan, Michael E Thase, Alan J Gelenberg, David J Kupfer, Darrel A Regier, Jerrold F Rosenbaum, Oakley Ray, Alan F Schatzberg. (2006) Report by the ACNP Task Force on Response and Remission in Major Depressive Disorder. Neuropsychopharmacology 31:9, 1841-1853
CrossRef182
Stewart E. Cooper, Suhayl J. Nasr. (2006) Combining Psychotherapy and Medication for College Students with Severe Psychopathology. Journal of College Student Psychotherapy 21:1, 33-50
CrossRef183
Richard K. Morriss, Jan Scott. (2006) Psychological management of mood disorders. Psychiatry 5:6, 185-188
CrossRef184
Timothy Scott. (2006) Tricks of the Trade. Ethical Human Psychology and Psychiatry 8:2, 133-146
CrossRef185
Mazda Adli, Michael Bauer, A. John Rush. (2006) Algorithms and Collaborative-care Systems for Depression: Are They Effective and Why?. Biological Psychiatry 59:11, 1029-1038
CrossRef186
William M. McDonald, Paul E. Holtzheimer, Eve H. Byrd. (2006) The diagnosis and treatment of depression in parkinson’s disease. Current Treatment Options in Neurology 8:3, 245-255
CrossRef187
Mark J. Millan. (2006) Multi-target strategies for the improved treatment of depressive states: Conceptual foundations and neuronal substrates, drug discovery and therapeutic application. Pharmacology & Therapeutics 110:2, 135-370
CrossRef188
Stephanie W. Kuffel, Julia R. Heiman. (2006) Effects of Depressive Symptoms and Experimentally Adopted Schemas on Sexual Arousal and Affect in Sexually Healthy Women. Archives of Sexual Behavior 35:2, 160-174
CrossRef189
Rona L. Levy, Kevin W. Olden, Bruce D. Naliboff, Laurence A. Bradley, Carlos Francisconi, Douglas A. Drossman, Francis Creed. (2006) Psychosocial Aspects of the Functional Gastrointestinal Disorders. Gastroenterology 130:5, 1447-1458
CrossRef190
E. Schramm, F. Caspar, M. Berger. (2006) Spezifische Therapie für chronische Depression. Der Nervenarzt 77:3, 355-371
CrossRef191
I. Harpaz-Rotem, R. A. Rosenheck. (2006) Prescribing practices of psychiatrists and primary care physicians caring for children with mental illness. Child: Care, Health and Development 32:2, 225-238
CrossRef192
Wayne J. Katon, Ming-Yu Fan, Elizabeth H. B. Lin, Jürgen Unützer. (2006) Depressive Symptom Deterioration in a Large Primary Care-Based Elderly Cohort. American Journal of Geriatric Psychiatry 14:3, 246-254
CrossRef193
J. A. Talbott. (2006) The chronic psychiatric patient: problems, promises and perspectives, past, present and future. Acta Psychiatrica Scandinavica 113:s429, 101-108
CrossRef194
Ann Mol, Bernard Sabbe. (2006) James P. McCullough (2000). Treatment for chronic depression: Cognitive behavioral analysis system of psychotherapy. New York: Guilford Press. 326 pp., £19,95. Tijdschrift voor Psychotherapie 32:1, 31-33
CrossRef195
Charles B. Nemeroff, J. Douglas Bremner, Edna B. Foa, Helen S. Mayberg, Carol S. North, Murray B. Stein. (2006) Posttraumatic stress disorder: A state-of-the-science review. Journal of Psychiatric Research 40:1, 1-21
CrossRef196
Susan L. McElroy, Renu Kotwal, Erik B Nelson, Shishuka Malhotra, Paul E Keck, Charles B Nemeroff. 2006. Obesity and Mood Disorders. , 41-92.
CrossRef197
Paul E. Holtzheimer, Charles B. Nemeroff. (2006) Advances in the treatment of depression. NeuroRX 3:1, 42-56
CrossRef198
Maurizio Fava, A. John Rush. (2006) Current Status of Augmentation and Combination Treatments for Major Depressive Disorder: A Literature Review and a Proposal for a Novel Approach to Improve Practice. Psychotherapy and Psychosomatics 75:3, 139-153
CrossRef199
Susan L. McElroy, Renu Kotwal, Paul E. Keck. 2006. Medical Management of Obesity Associated with Mood Disorders. , 369-416.
CrossRef200
Jun Ma, Ky-Van Lee, Randall S. Stafford. (2005) Depression treatment during outpatient visits by U.S. children and adolescents. Journal of Adolescent Health 37:6, 434-442
CrossRef201
Neil J. Santiago, Daniel N. Klein, Dina Vivian, Bruce A. Arnow, Janice A. Blalock, James H. Kocsis, John C. Markowitz, Rachel Manber, Lawrence P. Riso, Barbara O. Rothbaum, A. John Rush, Michael E. Thase, James P. McCullough, Martin B. Keller. (2005) The Therapeutic Alliance and CBASP-Specific Skill Acquisition in the Treatment of Chronic Depression. Cognitive Therapy and Research 29:6, 803-817
CrossRef202
Warren Mansell, Francesc Colom, Jan Scott. (2005) The nature and treatment of depression in bipolar disorder: A review and implications for future psychological investigation. Clinical Psychology Review 25:8, 1076-1100
CrossRef203
John C. Markowitz, James H. Kocsis, Kathryn L. Bleiberg, Paul J. Christos, Michael Sacks. (2005) A comparative trial of psychotherapy and pharmacotherapy for “pure” dysthymic patients. Journal of Affective Disorders 89:1-3, 167-175
CrossRef204
Bruce A. Arnow. (2005) Cognitive behavioral analysis system of psychotherapy for chronic depression. Cognitive and Behavioral Practice 12:1, 6-16
CrossRef205
Thomas E. Joiner, Jessica S. Brown, Kathryn H. Gordon, Mark R. Rouleau, Karen Dineen Wagner. (2005) Attributional Style, Hope, and Initial Response to Selective Serotonin Reuptake Inhibitors Youth Psychiatric Inpatients. Cognitive Therapy and Research 29:6, 691-704
CrossRef206
Richard C. Friedman, Webb B. Garrison, Wilma Bucci, Bernard S. Gorman. (2005) Factors Affecting Change in Private Psychotherapy Patients of Senior Psychoanalysts: An Effectiveness Study. The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry 33:4, 583-610
CrossRef207
Nancy L. Talbot, Yeates Conwell, Michael W. O??Hara, Scott Stuart, Erin A. Ward, Stephanie A. Gamble, Arthur Watts, Xin Tu. (2005) Interpersonal Psychotherapy for Depressed Women With Sexual Abuse Histories. The Journal of Nervous and Mental Disease 193:12, 847-850
CrossRef208
Michael Williams, Adriane Budavari, Kevin W Olden, Michael P Jones. (2005) Psychosocial Assessment of Functional Gastrointestinal Disorders in Clinical Practice. Journal of Clinical Gastroenterology 39:10, 847-857
CrossRef209
Michael A. Perelman. (2005) Psychosocial Evaluation and Combination Treatment of Men with Erectile Dysfunction. Urologic Clinics of North America 32:4, 431-445
CrossRef210
Bessel A. van der Kolk, Susan Roth, David Pelcovitz, Susanne Sunday, Joseph Spinazzola. (2005) Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress 18:5, 389-399
CrossRef211
Jessica S. Brown, Nadia E. Stellrecht, Foluso M. Williams, Jillian M. Denoma, LaRicka R. Wingate, Elizabeth N. Lima, Lorraine R. Reitzel, Thomas E. Joiner. (2005) A Comparison of Therapy Alone Versus Therapy and Medication in a Community Clinic. Journal of Cognitive Psychotherapy 19:4, 309-316
CrossRef212
Marilyn Byrne, Robert Edmundson, Eric D. Rankin. (2005) Symptom Reduction and Enhancement of Psychosocial Functioning Utilizing a Relational Group Treatment Program for Dependent/Codependent Population. Alcoholism Treatment Quarterly 23:4, 69-84
CrossRef213
Nicole F. Church, Margaret L. Brechman-Toussaint, Donald W. Hine. (2005) Do dysfunctional cognitions mediate the relationship between risk factors and postnatal depression symptomatology?. Journal of Affective Disorders 87:1, 65-72
CrossRef214
Janice A. Blalock, Rachel T. Fouladi, David W. Wetter, Paul M. Cinciripini. (2005) Depression in pregnant women seeking smoking cessation treatment. Addictive Behaviors 30:6, 1195-1208
CrossRef215
Brian R. McFarland, Daniel N. Klein. (2005) Mental health service use by patients with dysthymic disorder: treatment use and dropout in a 7 1/2-year naturalistic follow-up study. Comprehensive Psychiatry 46:4, 246-253
CrossRef216
RODGER KESSLER. (2005) Treating Psychological Problems in Medical Settings: Primary Care as the De Facto Mental Health System and the Role of Hypnosis. International Journal of Clinical and Experimental Hypnosis 53:3, 290-305
CrossRef217
John J. Barry, Jana E. Jones. (2005) What is effective treatment of depression in people with epilepsy?. Epilepsy & Behavior 6:4, 520-528
CrossRef218
W. Edward Craighead, Erin S. Sheets, Andri S. Bjornsson. (2005) Specificity and Nonspecificity in Psychotherapy. Clinical Psychology: Science and Practice 12:2, 189-193
CrossRef219
Douglas A Drossman. (2005) What Does the Future Hold for Irritable Bowel Syndrome and the Functional Gastrointestinal Disorders?. Journal of Clinical Gastroenterology 39:Supplement 3, S251-S256
CrossRef220
S. McPherson, P. Cairns, J. Carlyle, D. A. Shapiro, P. Richardson, D. Taylor. (2005) The effectiveness of psychological treatments for treatment-resistant depression: a systematic review.. Acta Psychiatrica Scandinavica 111:5, 331-340
CrossRef221
Frank G Gilliam. (2005) Diagnosis and treatment of mood disorders in persons with epilepsy. Current Opinion in Neurology 18:2, 129-133
CrossRef222
Eliana Tossani, Paolo Cassano, Maurizio Fava. (2005) PSYCHOSOCIAL FACTORS IN PATIENTS WITH CHRONIC KIDNEY DISEASE: Depression and Renal Disease. Seminars in Dialysis 18:2, 73-81
CrossRef223
T. J. Huber. (2005) Station
re Depressionsbehandlung. Der Nervenarzt 76:3, 270-277
CrossRef224
Michael W. Otto, Jasper A. J. Smits, Hannah E. Reese. (2005) Combined Psychotherapy and Pharmacotherapy for Mood and Anxiety Disorders in Adults: Review and Analysis. Clinical Psychology: Science and Practice 12:1, 72-86
CrossRef225
A. John Rush. (2005) Reply. Biological Psychiatry 57:3, 314-315
CrossRef226
Arnold Winston, Harold Been, Michael Serby. (2005) Psychotherapy and Psychopharmacology: Different Universes or an Integrated Future?. Journal of Psychotherapy Integration 15:2, 213-223
CrossRef227
Phil S. Lebovitz. (2004) Integrating Psychoanalysis and Psychopharmacology: A Review of the Literature of Combined Treatment for Affective Disorders. The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry 32:4, 585-596
CrossRef228
Francesc Colom, Eduard Vieta. (2004) A perspective on the use of psychoeducation, cognitive-behavioral therapy and interpersonal therapy for bipolar patients. Bipolar Disorders 6:6, 480-486
CrossRef229
Rachel Manber, Rosa N. Schnyer, John J.B. Allen, A. John Rush, Christine M. Blasey. (2004) Acupuncture: a promising treatment for depression during pregnancy. Journal of Affective Disorders 83:1, 89-95
CrossRef230
John Swan, Eleanor Sorrell, Bob MacVicar, Rob Durham, Keith Matthews. (2004) “Coping with depression”: an open study of the efficacy of a group psychoeducational intervention in chronic, treatment-refractory depression. Journal of Affective Disorders 82:1, 125-129
CrossRef231
KENNETH BELZER, FRANKLIN R. SCHNEIER. (2004) Comorbidity of Anxiety and Depressive Disorders: Issues in Conceptualization, Assessment, and Treatment. Journal of Psychiatric Practice 10:5, 296-306
CrossRef232
SCOTT M BEA, MEGAN DELEON. (2004) All Stressed Up With No Place to Go: A Brief Guide to Psychotherapy Referrals for Primary Care Providers, Including Obstetricians and Gynecologists. Clinical Obstetrics and Gynecology 47:3, 597-607
CrossRef233
LEN SPERRY. (2004) Effective Couples Therapy and Psych 101: You Can't Have One Without the Other. The American Journal of Family Therapy 32:4, 325-335
CrossRef234
Jason H. King, Shannon M. Anderson. (2004) Therapeutic Implications of Pharmacotherapy: Current Trends and Ethical Issues. Journal of Counseling & Development 82:3, 329-336
CrossRef235
(2004) Australian and New Zealand clinical practice guidelines for the treatment of depression. Australian and New Zealand Journal of Psychiatry 38:6, 389-407
CrossRef236
Cathy Sherbourne, Michael Schoenbaum, Kenneth B Wells, Thomas W Croghan. (2004) Characteristics, treatment patterns, and outcomes of persistent depression despite treatment in primary care. General Hospital Psychiatry 26:2, 106-114
CrossRef237
David H. Barlow, Laura B. Allen, Molly L. Choate. (2004) Toward a unified treatment for emotional disorders. Behavior Therapy 35:2, 205-230
CrossRef238
Michael A. Friedman, Jerusha B. Detweiler-Bedell, Howard E. Leventhal, Rob Home, Gabor I. Keitner, Ivan W. Miller. (2004) Combined Psychotherapy and Pharmacotherapy for the Treatment of Major Depressive Disorder. Clinical Psychology: Science and Practice 11:1, 47-68
CrossRef239
Benjamin JDH Chun, David L Dunner. (2004) A review of antidepressant-induced hypomania in major depression: suggestions for DSM-V. Bipolar Disorders 6:1, 32-42
CrossRef240
Ian B. Hickie. (2004) Commentary on ‘Evaluating treatments for the mood disorders: time for the evidence to get real’. Australian and New Zealand Journal of Psychiatry 38:6, 415-418
CrossRef241
Francisca Azocar, Loren M. McCarter, Brian J. Cuffel, Thomas W. Croghan. (2004) Patterns of Medical Resource and Psychotropic Medicine Use Among Adult Depressed Managed Behavioral Health Patients. The Journal of Behavioral Health Services & Research 31:1, 26???37
CrossRef242
Daniel N. Klein, Neil J. Santiago, Dina Vivian, Janice A. Blalock, James H. Kocsis, John C. Markowitz, James P. McCullough, A. John Rush, Madhukar H. Trivedi, Bruce A. Arnow, David L. Dunner, Rachel Manber, Barbara Rothbaum, Michael E. Thase, Gabor I. Keitner, Ivan W. Miller, Martin B. Keller. (2004) Cognitive-Behavioral Analysis System of Psychotherapy as a Maintenance Treatment for Chronic Depression.. Journal of Consulting and Clinical Psychology 72:4, 681-688
CrossRef243
Carina Vocisano, Daniel N. Klein, Bruce Arnow, Caridad Rivera, Janice A. Blalock, Barbara Rothbaum, Dina Vivian, John C. Markowitz, James H. Kocsis, Rachel Manber, Louis Castonguay, A. John Rush, Frances E. Borian, James P. Mccullough, Susan G. Kornstein, Lawrence P. Riso, Michael E. Thase. (2004) Therapist Variables That Predict Symptom Change in Psychotherapy With Chronically Depressed Outpatients.. Psychotherapy: Theory, Research, Practice, Training 41:3, 255-265
CrossRef244
David H. Barlow. (2004) Psychological Treatments.. American Psychologist 59:9, 869-878
CrossRef245
Francisca Azocar, Loren M. McCarter, Brian J. Cuffel, Thomas W. Croghan. (2004) Patterns of medical resource and psychotropic medicine use among adult depressed managed behavioral health patients. The Journal of Behavioral Health Services & Research 31:1, 26-37
CrossRef246
Roger McIntyre, Martin Katzman. (2003) The role of atypical antipsychotics in bipolar depression and anxiety disorders. Bipolar Disorders 5:s2, 20-35
CrossRef247
Sidney H Kennedy, Raymond W Lam. (2003) Enhancing outcomes in the management of treatment resistant depression: a focus on atypical antipsychotics. Bipolar Disorders 5:s2, 36-47
CrossRef248
L Goetzmann, M Holzapfel, A Toygar. (2003) Psychotropic agents in psychotherapy—the subjective meaning of medication in different levels of self/object differentiation (neurosis, borderline, psychosis). International Journal of Psychotherapy 8:3, 213-222
CrossRef249
Diane Wuerth, Susan H. Finkelstein, Alan S. Kliger, Fredric O. Finkelstein. (2003) RENAL RESEARCH INSTITUTE SYMPOSIUM: Chronic Peritoneal Dialysis Patients Diagnosed with Clinical Depression: Results of Pharmacologic Therapy. Seminars in Dialysis 16:6, 424-427
CrossRef250
Alan J. Gelenberg, Madhukar H. Trivedi, A.John Rush, Michael E. Thase, Robert Howland, Daniel N. Klein, Susan G. Kornstein, David L. Dunner, John C. Markowitz, Robert M.A. Hirschfeld, Gabor I. Keitner, John Zajecka, James H Kocsis, James M. Russell, Ivan Miller, Rachel Manber, Bruce Arnow, Barbara Rothbaum, Melvin Munsaka, Phillip Banks, Frances E. Borian, Martin B. Keller. (2003) Randomized, Placebo-Controlled trial of nefazodone maintenance treatment in preventing recurrence in chronic depression. Biological Psychiatry 54:8, 806-817
CrossRef251
M. B. Keller. (2003) The lifelong course of social anxiety disorder: a clinical perspective. Acta Psychiatrica Scandinavica 108:s417, 85-94
CrossRef252
BRUCE WASLICK, DENA SCHOENHOLZ, RODRIGO PIZARRO. (2003) Diagnosis and Treatment of Chronic Depression in Children and Adolescents. Journal of Psychiatric Practice 9:5, 354-366
CrossRef253
A.John Rush, Madhukar H Trivedi, Hicham M Ibrahim, Thomas J Carmody, Bruce Arnow, Daniel N Klein, John C Markowitz, Philip T Ninan, Susan Kornstein, Rachel Manber, Michael E Thase, James H Kocsis, Martin B Keller. (2003) The 16-Item quick inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biological Psychiatry 54:5, 573-583
CrossRef254
James H. Kocsis. (2003) Pharmacotherapy for chronic depression. Journal of Clinical Psychology 59:8, 885-892
CrossRef255
James P. McCullough. (2003) Treatment for chronic depression using Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Journal of Clinical Psychology 59:8, 833-846
CrossRef256
J. Dekker, P. J. Molenaar, F. Jonghe. (2003) Langetermijneffectiviteit van gecombineerde behandeling bij ambulante depressieve patiënten. Tijdschrift voor Psychotherapie 29:4, 188-194
CrossRef257
Dominique L Musselman, Ephi Betan, Hannah Larsen, Lawrence S Phillips. (2003) Relationship of depression to diabetes types 1 and 2: epidemiology, biology, and treatment. Biological Psychiatry 54:3, 317-329
CrossRef258
John C. Markowitz. (2003) Interpersonal psychotherapy for chronic depression. Journal of Clinical Psychology 59:8, 847-858
CrossRef259
Yuichiro Suzuki, Akio Sakurai, Toshinobu Yasuda, Hiroaki Harai, Toshinori Kitamura, Kiyohisa Takahashi, Toshiaki A. Furukawa. (2003) Reliability, validity and standardization of the Japanese version of the Social Adjustment Scale-Self Report. Psychiatry and Clinical Neurosciences 57:4, 441-446
CrossRef260
Bruce A. Arnow, Michael J. Constantino. (2003) Effectiveness of psychotherapy and combination treatment for chronic depression. Journal of Clinical Psychology 59:8, 893-905
CrossRef261
(2003) Treatment for Adolescents With Depression Study (TADS): Rationale, Design, and Methods. Journal of the American Academy of Child & Adolescent Psychiatry 42:5, 531-542
CrossRef262
Louis G. Castonguay, Jack J. Reid, Gregory S. Halperin, Marvin R. Goldfried. 2003. Psychotherapy Integration. .
CrossRef263
W. Edward Craighead, Linda Wilcoxon Craighead. 2003. Behavioral and Cognitive-Behavioral Psychotherapy. .
CrossRef264
A. M. Zeiss. (2003) DEPRESSION IN OLDER ADULTS: EVIDENCE-BASED TREATMENT AND CURRENT GAPS IN THE EVIDENCE BASE. The Gerontologist 43:2, 279-283
CrossRef265
Jill Littrell. (2003) Obtaining Informed Consent When a Profession Labels Itself as Providing Treatment for Mental Illness. Social Work in Mental Health 1:4, 107-122
CrossRef266
MARK A. PAPWORTH, IAN A. JAMES. (2003) Createativity and Mood: Towards a Model of Cognitive Mediation. The Journal of Creative Behavior 37:1, 1-16
CrossRef267
Wei Jiang, James A. Blumenthal. (2003) Depression and ischemic heart disease: Overview of the evidence and treatment implications. Current Psychiatry Reports 5:1, 47-54
CrossRef268
L. Kathleen Sekula, Joe DeSantis, Vincent Gianetti. (2003) Considerations in the Management of the Patient with Comorbid Depression and Anxiety. Journal of the American Academy of Nurse Practitioners 15:1, 23-33
CrossRef269
Richard O'Connor. (2003) An integrative approach to treatment of depression.. Journal of Psychotherapy Integration 13:2, 130-170
CrossRef270
Thomas R. Lynch, Jennifer Q. Morse, Tamar Mendelson, Clive J. Robins. (2003) Dialectical Behavior Therapy for Depressed Older Adults. American Journal of Geriatric Psychiatry 11:1, 33-45
CrossRef271
David L Dunner. (2003) Current therapeutic approaches for dysthymic disorder. Expert Review of Neurotherapeutics 3:1, 119-125
CrossRef272
Daniel N. Klein, Joseph E. Schwartz, Neil J. Santiago, Dina Vivian, Carina Vocisano, Louis G. Castonguay, Bruce Arnow, Janice A. Blalock, Rachel Manber, John C. Markowitz, Lawrence P. Riso, Barbara Rothbaum, James P. McCullough, Michael E. Thase, Frances E. Borian, Ivan W. Miller, Martin B. Keller. (2003) Therapeutic Alliance in Depression Treatment: Controlling for Prior Change and Patient Characteristics.. Journal of Consulting and Clinical Psychology 71:6, 997-1006
CrossRef273
David O. Antonuccio, William G. Danton, Terry Michael McClanahan. (2003) Psychology in the Prescription Era: Building a Firewall Between Marketing and Science.. American Psychologist 58:12, 1028-1043
CrossRef274
James P., Jr. McCullough, Daniel N. Klein, Frances E. Borian, Robert H. Howland, Lawrence P. Riso, Martin B. Keller, Phillip L. C. Banks. (2003) Group Comparisons of DSM-IV Subtypes of Chronic Depression: Validity of the Distinctions, Part 2.. Journal of Abnormal Psychology 112:4, 614-622
CrossRef275
Usha Sambamoorthi, Mark Olfson, James T. Walkup, Stephen Crystal. (2003) Diffusion of New Generation Antidepressant Treatment Among Elderly Diagnosed With Depression. Medical Care 41:1, 180-194
CrossRef276
Jack M. Gorman, Jos
CrossRef277
Lawrence P. Riso, P. L. du Toit, Jaime A. Blandino, Suzanne Penna, Sean Dacey, Jason S. Duin, Elizabeth M. Pacoe, Merida M. Grant, Christi S. Ulmer. (2003) Cognitive aspects of chronic depression.. Journal of Abnormal Psychology 112:1, 72-80
CrossRef278
Bruce A. Arnow, Rachel Manber, Christine Blasey, Daniel N. Klein, Janice A. Blalock, John C. Markowitz, Barbara O. Rothbaum, A. John Rush, Michael E. Thase, Lawrence P. Riso, Dina Vivian, James P., Jr. McCullough, Martin B. Keller. (2003) Therapeutic Reactance as a Predictor of Outcome in the Treatment of Chronic Depression.. Journal of Consulting and Clinical Psychology 71:6, 1025-1035
CrossRef279
Anne Fleming, Stuart Eisendrath. 2003. Depression. , 853-860.
CrossRef280
Ruth E. Levine. 2003. Dysthymia. , 62-65.
CrossRef281
James P. McCullough. (2002) What Questions Are We Trying to Answer With Our Psychotherapy Research?. Clinical Psychology: Science and Practice 9:4, 447-452
CrossRef282
David Baldwin, Christel Buis, Andrew Mayers. (2002) Selective serotonin reuptake inhibitors in the treatment of generalized anxiety disorder. Expert Review of Neurotherapeutics 2:5, 717-724
CrossRef283
Steven D Hollon, Ricardo F Muñoz, David H Barlow, William R Beardslee, Carl C Bell, Guillermo Bernal, Gregory N Clarke, L.Patt Franciosi, Alan E Kazdin, Laura Kohn, Marsha M Linehan, John C Markowitz, David J Miklowitz, Jacqueline B Persons, George Niederehe, David Sommers. (2002) Psychosocial intervention development for the prevention and treatment of depression: promoting innovation and increasing access. Biological Psychiatry 52:6, 610-630
CrossRef284
Brent, David A., Birmaher, Boris, . (2002) Adolescent Depression. New England Journal of Medicine 347:9, 667-671
Full Text285
H.George Nurnberg, Stuart N Seidman, Alan J Gelenberg, Maurizio Fava, Raymond Rosen, Ridwan Shabsigh. (2002) Depression, antidepressant therapies, and erectile dysfunction: clinical trials of sildenafil citrate (Viagra®) in treated and untreated patients with depression. Urology 60:2, 58-66
CrossRef286
Louis Rothschild, Mark Zimmerman. (2002) Personality Disorders and the Duration of Depressive Episode: A Retrospective Study. Journal of Personality Disorders 16:4, 293-303
CrossRef287
Kate E Hamilton, Keith S Dobson. (2002) Cognitive therapy of depression. Clinical Psychology Review 22:6, 875-893
CrossRef288
Nick Kanas, Molyn Leszcz. (2002) Group Therapy for Depression. International Journal of Group Psychotherapy 52:3, 449-457
CrossRef289
Gregory E Simon. (2002) Evidence review: efficacy and effectiveness of antidepressant treatment in primary care. General Hospital Psychiatry 24:4, 213-224
CrossRef290
Wayne Katon, Junius Gonzales. (2002) Primary care and treatment of depression: a response to the NIMH “White Papers”. General Hospital Psychiatry 24:4, 194-196
CrossRef291
Gina Browne, Meir Steiner, Jacqueline Roberts, Amiram Gafni, Carolyn Byrne, Edward Dunn, Barbara Bell, Michael Mills, Lori Chalklin, David Wallik, James Kraemer. (2002) Sertraline and/or interpersonal psychotherapy for patients with dysthymic disorder in primary care: 6-month comparison with longitudinal 2-year follow-up of effectiveness and costs. Journal of Affective Disorders 68:2-3, 317-330
CrossRef292
GREGORY N. CLARKE, MARK HORNBROOK, FRANCES LYNCH, MICHAEL POLEN, JOHN GALE, ELIZABETH O’CONNOR, JOHN R. SEELEY, LYNN DEBAR. (2002) Group Cognitive-Behavioral Treatment for Depressed Adolescent Offspring of Depressed Parents in a Health Maintenance Organization. Journal of the American Academy of Child & Adolescent Psychiatry 41:3, 305-313
CrossRef293
(2002) Non-adherence in psychiatric disorders: misbehaviour or clinical feature?. Acta Psychiatrica Scandinavica 105:3, 161-163
CrossRef294
Julia R. Heiman. (2002) Sexual dysfunction: Overview of prevalence, etiological factors, and treatments. Journal of Sex Research 39:1, 73-78
CrossRef295
David L. Dunner, Helen E. Hendricksen, Carolyn Bea, Chris B. Budech, S.D. Friedman. (2002) Dysthymic disorder: Treatment with citalopram. Depression and Anxiety 15:1, 18-22
CrossRef296
Katalin Szanto, Ariel Gildengers, Benoit H. Mulsant, Greg Brown, George S. Alexopoulos, Charles F. Reynolds. (2002) Identification of Suicidal Ideation and Prevention of Suicidal Behaviour in the Elderly. Drugs & Aging 19:1, 11-24
CrossRef297
Esteban V. Cardemil. 2002. Depression. , 101-113.
CrossRef298
Robert M.A Hirschfeld, David L Dunner, Gabor Keitner, Daniel N Klein, Lorrin M Koran, Susan G Kornstein, John C Markowitz, Ivan Miller, Charles B Nemeroff, Philip T Ninan, A.John Rush, Alan F Schatzberg, Michael E Thase, Madhukar H Trivedi, Frances E Borian, Paul Crits-Christoph, Martin B Keller. (2002) Does psychosocial functioning improve independent of depressive symptoms? a comparison of nefazodone, psychotherapy, and their combination. Biological Psychiatry 51:2, 123-133
CrossRef299
Steven D. Hollon. (2001) Behavioral Activation Treatment for Depression: A Commentary. Clinical Psychology: Science and Practice 8:3, 271-274
CrossRef300
DAVID J. HELLERSTEIN. (2001) Dysthymic Disorder: Integrating Research Findings into Clinical Treatment. Journal of Psychiatric Practice 7:5, 298-309
CrossRef301
Mary Jo Coiro. (2001) Depressive Symptoms Among Women Receiving Welfare. Women & Health 32:1-2, 1-23
CrossRef302
J. Spijker, R. V. Bijl, R. de Graaf, W. A. Nolen. (2001) Care utilization and outcome of DSM-III-R major depression in the general population. Results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatrica Scandinavica 104:1, 19-24
CrossRef303
ALAN A. STONE. (2001) Psychotherapy in the Managed Care Health Market. Journal of Psychiatric Practice 7:4, 238-243
CrossRef304
Abhijit Chaudhuri. (2001) Cognitive behaviour therapy for chronic fatigue syndrome. The Lancet 358:9277, 238
CrossRef305
W. Edward Craighead, Linda Wilcoxon Craighead. (2001) THE ROLE OF PSYCHOTHERAPY IN TREATING PSYCHIATRIC DISORDERS. Medical Clinics of North America 85:3, 617-629
CrossRef306
Diane Wuerth, Susan H. Finkelstein, James Ciarcia, Roberta Peterson, Alan S. Kliger, Fredric O. Finkelstein. (2001) Identification and treatment of depression in a cohort of patients maintained on chronic peritoneal dialysis. American Journal of Kidney Diseases 37:5, 1011-1017
CrossRef307
J. David Moore, Joseph R. Bona. (2001) DEPRESSION AND DYSTHYMIA. Medical Clinics of North America 85:3, 631-644
CrossRef308
E Richelson. (2001) Pharmacology of antidepressants.. Mayo Clinic Proceedings 76:5, 511-527
CrossRef309
Julie Magno Zito, Daniel J. Safer. (2001) Antidepressant treatment in children and adolescents: Bridging the gap between efficacy and effectiveness. Current Psychiatry Reports 3:2, 115-125
CrossRef310
(2001) Of Two Minds. New England Journal of Medicine 344:12, 937-938
Full Text311
Gary J. Kennedy. (2001) New Drugs for Old Folks: The Evidence-Based Argument for Newer Antidepressants. Journal of the American Geriatrics Society 49:2, 227-228
CrossRef312
Hagop S. Akiskal. (2001) Dysthymia and cyclothymia in psychiatric practice a century after Kraepelin. Journal of Affective Disorders 62:1-2, 17-31
CrossRef313
Thomas Yang, David L. Dunner. (2001) Differential subtyping of depression. Depression and Anxiety 13:1, 11-17
CrossRef314
Steven D. Hollon, Richard C. Shelton. (2001) Treatment guidelines for major depressive disorder. Behavior Therapy 32:2, 235-258
CrossRef315
Richard Balon. (2001) Anxiety across the life span: Epidemiological evidence and treatment data. Depression and Anxiety 13:4, 184-189
CrossRef316
Whooley, Mary A., Simon, Gregory E., . (2000) Managing Depression in Medical Outpatients. New England Journal of Medicine 343:26, 1942-1950
Full Text317
(2000) Nefazodone, Psychotherapy, and Their Combination for Chronic Depression. New England Journal of Medicine 343:14, 1041-1043
Full Text318
Edward Stepanski, James K Wyatt. (2000) Controversies in the treatment of primary insomnia. Sleep Medicine 1:4, 259-261
CrossRef319
A. John Rush, Peter Polatin, Robert J. Gatchel. (2000) Depression and Chronic Low Back Pain. Spine 25:20, 2566-2571
CrossRef320
(2000) Current Awareness. Human Psychopharmacology: Clinical and Experimental 15:7, 567-572
CrossRef321
Angell, Marcia, . (2000) Is Academic Medicine for Sale?. New England Journal of Medicine 342:20, 1516-1518
Full Text322
Scott, Jan, . (2000) Treatment of Chronic Depression. New England Journal of Medicine 342:20, 1518-1520
Full Text323
&NA;. (2000) Nefazodone plus psychotherapy: best way to beat the blues?. Inpharma Weekly &NA;:1239, 13
CrossRef324
Joan Kaufman, Dennis Charney. (2000) Comorbidity of mood and anxiety disorders. Depression and Anxiety 12:S1, 69-76
CrossRef
- Letters
