New Strategies for Treating Chronic Depression

This article provides an update on the diagnosis of chronic depression subtypes, the clinical andpublic health significance of chronic depression, and a review of what is known about its treatment.The efficacy of antidepressant medications for pure dysthymia and double depression has been established,yet fewer than 50% of patients have achieved full remission with a single agent. Traditional antidepressantpsychotherapies appear to have limited effectiveness for chronic depression. In one recentstudy, a combination of cognitive behavioral analysis system of psychotherapy and a newer antidepressant,nefazodone, yielded the highest response and remission rates ever reported in this population(73% response rate, 48% remission rate in an intent-to-treat sample). This combination merits furtherstudy for treatment of chronic depression.