{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T23:08:54Z","timestamp":1781392134325,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2003,6,6]],"date-time":"2003-06-06T00:00:00Z","timestamp":1054857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clin Psychol"],"published-print":{"date-parts":[[2003,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although considerable research has been conducted on the efficacy of psychotherapy for depression, with and without medication, relatively few studies have focused on chronic forms of depression. Approximately 20% of individuals with depression experience episodes that last for two years or longer. We review the controlled research on the effectiveness of treatments separately for dysthymia and chronic major depression, focusing on the practical implications of the research for clinicians. In trials conducted with dysthymics, medication has been superior to psychotherapy, with limited evidence that combined treatment has advantages over medication or psychotherapy alone. In chronic major depression, combined treatment has demonstrated significant superiority over medication or psychotherapy alone. Possible explanations for the discrepant findings among dysthymics and those with chronic major depression are discussed. \u00a9 2003 Wiley Periodicals, Inc. J Clin Psychol\/In Session.<\/jats:p>","DOI":"10.1002\/jclp.10181","type":"journal-article","created":{"date-parts":[[2003,7,9]],"date-time":"2003-07-09T10:06:22Z","timestamp":1057745182000},"page":"893-905","source":"Crossref","is-referenced-by-count":104,"title":["Effectiveness of psychotherapy and combination treatment for chronic depression"],"prefix":"10.1002","volume":"59","author":[{"given":"Bruce A.","family":"Arnow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Constantino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,6,6]]},"reference":[{"key":"e_1_2_1_2_1","unstructured":"Arnow B.A. Blalock J. Rothbaum B.O. McCullough J.P. Markowitz J.C. &Barlow D.H.(2000 August).Comparison of medication psychotherapy and combination treatment for chronic depression. Symposium presented at the 108th annual meeting of the American Psychological Association Washington DC."},{"key":"e_1_2_1_3_1","first-page":"405","article-title":"Treatment of dysthymia and minor depression in primary care: A randomized trial in patients aged 18\u201359 years","volume":"50","author":"Barrett J.E.","year":"2001","journal-title":"Journal of Family Practice"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.63.1.125"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(01)00343-3"},{"key":"e_1_2_1_6_1","first-page":"81","volume-title":"Counseling based on process research: Applying what we know","author":"Constantino M.J.","year":"2002"},{"key":"e_1_2_1_7_1","first-page":"117","article-title":"A randomized controlled trial comparing moclobemide and moclobemide plus interpersonal psychotherapy in the treatment of dysthymic disorder","volume":"10","author":"De Mello M.F.","year":"2001","journal-title":"Journal of Psychotherapy Practice & Research"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01173752"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-7162(1996)4:1<34::AID-DEPR4>3.0.CO;2-F"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.9.816"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1991.01810360017002"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(98)00129-3"},{"key":"e_1_2_1_13_1","unstructured":"Gelenberg A.J. Trivedi M.H. Rush A.J. Thase M.E. Howland R. Klein D.N. Kornstein S.G. Dunner D.L. Markowitz J.C. Hirschfeld R.M.A. Keitner G.I. Zajecka J. Kocsis J.H. Russell J.M. Miller I. Manber R. Arnow B. Rothbaum B. Munsaka M. Banks P. Borian F.E. &Keller M.B.(in press).Randomized placebo\u2010controlled trial of Nefazodone maintenance treatment in preventing recurrence in chronic depression. Biological Psychiatry."},{"key":"e_1_2_1_14_1","first-page":"93","article-title":"Adding group psychotherapy to medication treatment in dysthymia. A randomized prospective pilot study","volume":"10","author":"Hellerstein D.J.","year":"2001","journal-title":"Journal of Psychotherapy Practice"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(01)01291-4"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(98)00138-4"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.9.1501"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005183422001"},{"key":"e_1_2_1_19_1","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.97.4.399"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(99)00020-8"},{"key":"e_1_2_1_21_1","unstructured":"Klein D.N. Schwartz J.E. Santiago N.J. Vivian D. Vocisano C. Castonguay L.G. Arnow B.A. Blalock J.A. Manber R. Markowitz J.C. Riso L.P. Rothbaum B. McCullough J.P. Thase M.E. Borian F. 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