None listed
Conditions
Brief summary
Depression is a common, often recurrent or chronic, serious health problem causing significant burden to individuals, their families and to society. The most evaluated psychotherapy, Cognitive Behaviour Therapy (CBT) is effective for around 50% of depressed individuals but relapse is common. Despite advances in knowledge about brain dysfunction and changes with recovery from depression, until recently there has been little integration of those findings with developments in the psychotherapy literature. Metacognitive Therapy (MCT) is a brief, innovative, targeted psychotherapy partly based on evidence of dysfunction in cognitive and emotional processing. We propose to treat 140 outpatients with depression in a randomised controlled trial of MCT vs. CBT. We hypothesise that MCT will act more rapidly and effectively in improving depression, with changes detectable on fMRI in a subset of participants. Being better able to understand how psychotherapies work in relation to brain function will contribute to development of better treatments.
Interventions
Participants will be randomised to receive 12 weeks of individual therapy;either Metacognitive therapy(MCT) or cognitive behaviour therapy (CBT). Most participants will receive 12 sessions in 12 weeks with 6 sessions in the first 4 weeks however the range permissible is 8 to 15 sessions over the 12 weeks. Therapy sessions last up to 1 hr. Clinical psychologists deliver both therapies and follow the work of AT Beck and J Beck for CBT(1,2) and of Adrian Wells and Costas Papageorgiou for MCT (3,4)
Participants will be randomised to receive 12 weeks of individual therapy;either Metacognitive therapy(MCT) or cognitive behaviour therapy (CBT). Most participants will receive 12 sessions in 12 weeks with 6 sessions in the first 4 weeks however the range permissible is 8 to 15 sessions over the 12 weeks. Therapy sessions last up to 1 hr. Clinical psychologists deliver both therapies and follow the work of AT Beck and J Beck for CBT(1,2) and of Adrian Wells and Costas Papageorgiou for MCT (3,4). References 1. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. Guildford Press, New York,1979. 2. Beck JS. Cognitive therapy: basics and beyond. The Guilford Press, New York, 1995. 3. Wells A. Metacognitive Therapy for Anxiety and Depression The Guilford Press; 2009. 4. Papageorgiou C, Wells A, eds. Depressive rumination: nature, theory and treatment. John Wiley, West Sussex, England, 2004.
Sponsors
Jennifer Jordan
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Current major depressive disorder (DSM-IV) Able to complete questionnaires and psychotherapy in the english language.
Exclusion criteria
On no psychoactive drugs (e.g. antidepressants, mood stabilisers, anxiolytics or antipsychotic drugs), moderate or severe alcohol or drug dependence as a primary diagnosis, bipolar I disorder or schizophrenia, major physical illness or head injury which could interfere with the fMRI procedure, neuropsychological assessment or psychotherapy.
Outcome results
None listed