Long-term management of chronic depression.

Untreated major depression tends to either wax and wane, with repeated acute episodes, or persist in a chronic unremitting state, which occurs in up to 35% of depressed patients. After acute remission, those with treated chronic major depression are at high risk of depressive relapse and recurrence. Strategies to reduce the risk of relapse and recurrence include achieving full acute remission, continuing antidepressant treatment with optimal patient adherence, and adding modified cognitive-behavioral psychotherapy. This article will review data relevant to the long-term management of chronic major depression.