Faster Remission of Chronic Depression With Combined Psychotherapy and Medication Than With Each Therapy Alone

Rachel Manber, Helena C. Kraemer, Bruce A. Arnow, Madhukar H. Trivedi, A. John Rush, Michael E. Thase, Barbara O. Rothbaum, Daniel N. Klein, James H. Kocsis, Alan J. Gelenberg, Martin E. Keller

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


The main aim of the present novel reanalysis of archival data was to compare the time to remission during 12 weeks of treatment of chronic depression following antidepressant medication (n = 218), psychotherapy (n = 216), and their combination (n = 222). Cox regression survival analyses revealed that the combination of medication and psychotherapy produced full remission from chronic depression more rapidly than either of the single modality treatments, which did not differ from each other. Receiver operating characteristic curve analysis was used to explore predictors (treatment group, demographic, clinical, and psychosocial) of remission. For those receiving the combination treatment, the most likely to succeed were those with low baseline depression (24-item Hamilton Rating Scale for Depression [HRSD; M. Hamilton, 1967] score < 26) and those with high depression scores but low anxiety (HRSD ≥ 26 and Hamilton Anxiety Rating Scale [M. Hamilton, 1959] < 14). Both profiles were associated with at least 40% chance of attaining full remission. The model did not identify predictors for those receiving medication or psychotherapy alone, and it did not distinguish between the 2 monotherapies. The authors conclude that combined antidepressant medications and psychotherapy result in faster full remission of chronic forms of major depressive disorder.

Original languageEnglish (US)
Pages (from-to)459-467
Number of pages9
JournalJournal of Consulting and Clinical Psychology
Issue number3
StatePublished - Jun 2008


  • antidepressant medications
  • chronic depression
  • combined treatments
  • psychotherapy
  • remission

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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