None listed
Conditions
Brief summary
In this pilot study, adult consumers attending primary care, the private sector and Southern Mental Health Services, who have had recurrent major depression will be randomised to one of four conditions: 1. Mindfulness-based cognitive therapy (MBCT) 2. Medication alliance therapy (MAT) 3. MBCT and MAT combined, and 4. Treatment as usual. Randomisation Strategy: Participants will be randomised to one of the four conditions. People either not prescribed or fully compliant with medication will have their randomisation options restricted to either Mindfulness-Based Cognitive Therapy or Treatment As Usual, because Medication Alliance Technology is not relevant to their situation. MBCT will be delivered by clinical psychologists trained according to the MBCT manual modified for an Australian context. MAT will be administered by community health staff, eg practice nurses, trained according to a manual developed by the research group. The research evaluation is at three levels: A. Examination of the feasibility of delivery of training programs and interventions within the Australian primary care context. B. Evaluation of the MBCT and MAT training packages, for which the participating therapists will be engaged also as study participants. C. Participating consumers will be regularly assessed over 12 months with systematic interviews assessing depression and disability as outcomes, and also mindfulness and adherence as possible mediating factors in the effects of these two therapies.
Interventions
Participants will receive Mindfulness-Based Cognitive Therapy (MBCT) and Medication Alliance Technology (MAT), singly and in combination.
The overall aim of this project is to establish and trial the methodology for a thorough investigation of the efficacy of two therapeutic interventions, Mindfulness-Based Cognitive Therapy (MBCT) and Medication Alliance Technology (MAT), singly and in combination, in the prevention of depressive relapse in people who have had at least two previous episodes of
Participants will receive Mindfulness-Based Cognitive Therapy (MBCT) and Medication Alliance Technology (MAT), singly and in combination. The overall aim of this project is to establish and trial the methodology for a thorough investigation of the efficacy of two therapeutic interventions, Mindfulness-Based Cognitive Therapy (MBCT) and Medication Alliance Technology (MAT), singly and in combination, in the prevention of depressive relapse in people who have had at least two previous episodes of depression. This project is a complex study design (2x2 factorial) in which these two different treatments are delivered singly and in combination, and are compared against a treatment as usual control group. The duration of the intervention is 14 months from randomisation to the different treatment conditions. This includes administration of 5 follow up questionnaires.
Sponsors
Southern Synergy The Southern Health Adult Psychiatry Research, Training, & Evaluation Centre Monash University www.med.monash.edu.au/psychmed/units/southernsynergy
Study design
Allocation
Randomised controlled trial
Intervention model
Factorial
Primary purpose
Prevention
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Prescribed antidepressant medication or not;Ability to speak and read English fluently;Meeting DSM-IV TR criteria for three previous major depressive episodes; at least two of which must have occurred within the past five years, and one within the past two years.At assessment, score on the Hamilton Rating Scale for Depression of less than 10.At assessment, score with respect to antidepressant medication on the Adherence Scale of 5 or less.
Exclusion criteria
History of schizophrenia or schizoaffective disorder, bipolar disorder or cyclothymia;Current eating disorder or obsessive-compulsive disorder;Organic mental disorder or pervasive developmental delay;Current borderline or antisocial personality disorder;Current psychotherapy or counselling greater than or equal to once per week;Current practice of meditation more than once per week or yoga more than twice per week;Active medical illness to which depression is secondary.
Outcome results
None listed