Treatment of Chronic Depression

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Abstract
The majority of persons who have an acute episode of a major depressive disorder will have a response to the first or second treatment tried.1 In patients with mild or moderately severe episodes, treatment with antidepressant drugs and brief psychotherapies are equally effective; in those with severe episodes, medication is usually recommended.2 The treatment of chronic depression is more problematic, since in 20 to 30 percent of initial episodes, there is incomplete remission after two years.3,4 Patients with chronic depression have marked impairments in psychosocial function, poor responses to single therapies, and very high rates of use of health care . . .