Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination

John Zajecka, David L. Dunner, Alan J. Gelenberg, Robert M A Hirschfeld, Susan G. Kornstein, Philip T. Ninan, A. John Rush, Michael E. Thase, Madhukar H. Trivedi, Bruce A. Arnow, Frances E. Borian, Rachel Manber, Martin B. Keller

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: Changes in sexual interest/satisfaction and function are frequently associated with major depression and the use of some antidepressant treatments. This study compares the effects of antidepressant medication, psychotherapy, and combined treatment on sexual interest/satisfaction and function in patients with chronic major depression. Method: Outpatients with chronic forms of DSM-IV major depressive disorder (N = 681) were randomly assigned to 12 weeks of nefazodone, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), or combined nefazodone/CBASP. The Modified Rush Sexual Inventory was used to assess sexual functioning, and the 24-item Hamilton Rating Scale for Depression was used to assess depressive symptoms. Results: At baseline, 65% of men and 48% of women reported some sexual dysfunction. Statistically significant linear improvement in sexual interest/satisfaction was noted across all 3 treatment groups (p < .001). Additionally, significant improvement in sexual function was observed across all 3 treatment groups on a composite measure of female sexual function (p < .001). Controlling for depressive symptoms and gender, combined treatment produced greater improvement in total sexual interest/satisfaction than CBASP alone (p = .007), but was not significantly different from nefazodone alone. Improvement in depressive symptoms was associated with improved sexual interest/satisfaction for men and women and, for men, improved sexual functioning. Conclusion: Chronic depression is associated with high rates of sexual dysfunction. Treatment with nefazodone, CBASP, and combined treatment improved sexual interest/satisfaction, with greatest improvement observed with combined treatment.

Original languageEnglish (US)
Pages (from-to)709-716
Number of pages8
JournalJournal of Clinical Psychiatry
Volume63
Issue number8
StatePublished - Aug 2002

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Orgasm
Psychotherapy
Depression
Therapeutics
Antidepressive Agents
nefazodone
Major Depressive Disorder
Diagnostic and Statistical Manual of Mental Disorders
Outpatients
Equipment and Supplies

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Zajecka, J., Dunner, D. L., Gelenberg, A. J., Hirschfeld, R. M. A., Kornstein, S. G., Ninan, P. T., ... Keller, M. B. (2002). Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination. Journal of Clinical Psychiatry, 63(8), 709-716.

Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination. / Zajecka, John; Dunner, David L.; Gelenberg, Alan J.; Hirschfeld, Robert M A; Kornstein, Susan G.; Ninan, Philip T.; Rush, A. John; Thase, Michael E.; Trivedi, Madhukar H.; Arnow, Bruce A.; Borian, Frances E.; Manber, Rachel; Keller, Martin B.

In: Journal of Clinical Psychiatry, Vol. 63, No. 8, 08.2002, p. 709-716.

Research output: Contribution to journalArticle

Zajecka, J, Dunner, DL, Gelenberg, AJ, Hirschfeld, RMA, Kornstein, SG, Ninan, PT, Rush, AJ, Thase, ME, Trivedi, MH, Arnow, BA, Borian, FE, Manber, R & Keller, MB 2002, 'Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination', Journal of Clinical Psychiatry, vol. 63, no. 8, pp. 709-716.
Zajecka J, Dunner DL, Gelenberg AJ, Hirschfeld RMA, Kornstein SG, Ninan PT et al. Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination. Journal of Clinical Psychiatry. 2002 Aug;63(8):709-716.
Zajecka, John ; Dunner, David L. ; Gelenberg, Alan J. ; Hirschfeld, Robert M A ; Kornstein, Susan G. ; Ninan, Philip T. ; Rush, A. John ; Thase, Michael E. ; Trivedi, Madhukar H. ; Arnow, Bruce A. ; Borian, Frances E. ; Manber, Rachel ; Keller, Martin B. / Sexual function and satisfaction in the treatment of chronic major depression with nefazodone, psychotherapy, and their combination. In: Journal of Clinical Psychiatry. 2002 ; Vol. 63, No. 8. pp. 709-716.
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abstract = "Background: Changes in sexual interest/satisfaction and function are frequently associated with major depression and the use of some antidepressant treatments. This study compares the effects of antidepressant medication, psychotherapy, and combined treatment on sexual interest/satisfaction and function in patients with chronic major depression. Method: Outpatients with chronic forms of DSM-IV major depressive disorder (N = 681) were randomly assigned to 12 weeks of nefazodone, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), or combined nefazodone/CBASP. The Modified Rush Sexual Inventory was used to assess sexual functioning, and the 24-item Hamilton Rating Scale for Depression was used to assess depressive symptoms. Results: At baseline, 65{\%} of men and 48{\%} of women reported some sexual dysfunction. Statistically significant linear improvement in sexual interest/satisfaction was noted across all 3 treatment groups (p < .001). Additionally, significant improvement in sexual function was observed across all 3 treatment groups on a composite measure of female sexual function (p < .001). Controlling for depressive symptoms and gender, combined treatment produced greater improvement in total sexual interest/satisfaction than CBASP alone (p = .007), but was not significantly different from nefazodone alone. Improvement in depressive symptoms was associated with improved sexual interest/satisfaction for men and women and, for men, improved sexual functioning. Conclusion: Chronic depression is associated with high rates of sexual dysfunction. Treatment with nefazodone, CBASP, and combined treatment improved sexual interest/satisfaction, with greatest improvement observed with combined treatment.",
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AU - Dunner, David L.

AU - Gelenberg, Alan J.

AU - Hirschfeld, Robert M A

AU - Kornstein, Susan G.

AU - Ninan, Philip T.

AU - Rush, A. John

AU - Thase, Michael E.

AU - Trivedi, Madhukar H.

AU - Arnow, Bruce A.

AU - Borian, Frances E.

AU - Manber, Rachel

AU - Keller, Martin B.

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N2 - Background: Changes in sexual interest/satisfaction and function are frequently associated with major depression and the use of some antidepressant treatments. This study compares the effects of antidepressant medication, psychotherapy, and combined treatment on sexual interest/satisfaction and function in patients with chronic major depression. Method: Outpatients with chronic forms of DSM-IV major depressive disorder (N = 681) were randomly assigned to 12 weeks of nefazodone, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), or combined nefazodone/CBASP. The Modified Rush Sexual Inventory was used to assess sexual functioning, and the 24-item Hamilton Rating Scale for Depression was used to assess depressive symptoms. Results: At baseline, 65% of men and 48% of women reported some sexual dysfunction. Statistically significant linear improvement in sexual interest/satisfaction was noted across all 3 treatment groups (p < .001). Additionally, significant improvement in sexual function was observed across all 3 treatment groups on a composite measure of female sexual function (p < .001). Controlling for depressive symptoms and gender, combined treatment produced greater improvement in total sexual interest/satisfaction than CBASP alone (p = .007), but was not significantly different from nefazodone alone. Improvement in depressive symptoms was associated with improved sexual interest/satisfaction for men and women and, for men, improved sexual functioning. Conclusion: Chronic depression is associated with high rates of sexual dysfunction. Treatment with nefazodone, CBASP, and combined treatment improved sexual interest/satisfaction, with greatest improvement observed with combined treatment.

AB - Background: Changes in sexual interest/satisfaction and function are frequently associated with major depression and the use of some antidepressant treatments. This study compares the effects of antidepressant medication, psychotherapy, and combined treatment on sexual interest/satisfaction and function in patients with chronic major depression. Method: Outpatients with chronic forms of DSM-IV major depressive disorder (N = 681) were randomly assigned to 12 weeks of nefazodone, Cognitive Behavioral Analysis System of Psychotherapy (CBASP), or combined nefazodone/CBASP. The Modified Rush Sexual Inventory was used to assess sexual functioning, and the 24-item Hamilton Rating Scale for Depression was used to assess depressive symptoms. Results: At baseline, 65% of men and 48% of women reported some sexual dysfunction. Statistically significant linear improvement in sexual interest/satisfaction was noted across all 3 treatment groups (p < .001). Additionally, significant improvement in sexual function was observed across all 3 treatment groups on a composite measure of female sexual function (p < .001). Controlling for depressive symptoms and gender, combined treatment produced greater improvement in total sexual interest/satisfaction than CBASP alone (p = .007), but was not significantly different from nefazodone alone. Improvement in depressive symptoms was associated with improved sexual interest/satisfaction for men and women and, for men, improved sexual functioning. Conclusion: Chronic depression is associated with high rates of sexual dysfunction. Treatment with nefazodone, CBASP, and combined treatment improved sexual interest/satisfaction, with greatest improvement observed with combined treatment.

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