F33
Conditions
Interventions
Group 1: Psychoanalytical longterm treatment with 1 weekly session
Group 2: Psychoanalytical longterm treatment with 3-4 weekly session
Group 3: Healthy control group
Sponsors
International Psychoanalytic Association
Eligibility
Sex/Gender
All
Age
21 Years to 60 Years
Inclusion criteria
Inclusion criteria: Diagnosis of major depression or dysthymia (based on Structural Clinical Interview-SCID) for at least 12 months QIDS-C score > 9, BDI 2 > 17 Age: 21-60 years CTQ: at least trauma at one of the subscales (selfratings of the patients, ratings of SCID interviewer) Sufficient knowledge of local language Informed consent to study protocol Willing to be treated without antidepressand medication for one year (except in emergency situations)
Exclusion criteria
Exclusion criteria: Current or past psychotic symptomatology, schizoaffective, schizophrenic, or bipolar affective disorder Substance dependence current or during the last three years Dementia Borderline, schizotypal and antisocial personality disorder Acute suicidality Restriction of intellectual capacity Serious physical illness that strongly affects the depression or is causal for the depression Concurrent psychotherapeutic treatment Technical exclusion criteria for MRI (metallic tattoos, pacemakers, or other metal parts in the body etc., according to special guidelines of the local MRI teams
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary Outcomes: MRI Brain Measures Assessment will comprise the following MRI brain measures. Anatomical MRI: measures of cortical thickness at all points across the cerebrum. Resting State Functional MRI (rsfMRI): measures of functional connectivity throughout the brain. Cyberball Task-Related Functional MRI (fMRI): measures of brain activation throughout the brain in response to trust, mistrust (social exclusion), and rebuilding of trust (social re-inclusion). Diffusion Tensor Imaging (DTI): measures of fractional anisotropy and average diffusion coefficient. What these outcomes tell us about the brain MRI is an entirely safe way of imaging the brain at any age. It is routinely performed in unsedated people at multiple time points, including multiple time points within an RCT, and without the need for exposure to any radioactivity. MRI scanning can be performed in different modes, with each modality providing unique information probing different aspects of the brain’s structural and functional organization. Anatomical MRI provides information about brain structure, most commonly the volumes and shapes of particular brain regions. Diffusion Tensor Imaging (DTI) provides information about tissue organization within the brain, especially white matter fibers that connect one brain region to another. At each voxel, Fractional Anisotropy (FA) measures the directional diffusion of water, Mean Diffusivity (MD) measures the overall diffusion of water, Axial Diffusivity (AD) measures diffusion along the long axis of diffusion, which is presumed to be along the long axis of the fiber bundle, and Radial Diffusivity (RD) measures diffusion perpendicular to the long axis of diffusion or fiber bundle. Functional MRI (fMRI) provides measures of time-dependent changes in the relative concentration of deoxyhemoglobin within each voxel, which itself is driven largely by changes in oxygen use and the underlying changes in neuronal activity within the voxel. Measures of resting sta | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcome measures MODE will investigate whether and how brain changes are associated with common measures of change for patients with chronic depression and early trauma after one year of treatment. To achieve this aim and as recommended in meta-analytic reviews, various broad areas of patient’s functioning are assessed including (1) psychopathology, (2) personality, social and work functioning, and (3) dynamic functioning which may underlie impaired functioning and contribute to vulnerability to psychiatric disorders. Due to their depressive symptomatology, patients may face some difficulties with self-report questionnaires. Therefore, we have restricted the total number of items included in the assessment battery. Measuring instruments: T0 (before the start of the intervention): Interviews: - SCID by independent interviewer - Initial psychoanalytic interview by clinician - Global Assessment Scale (GAS) Questionnaires: - BDI (Beck Depression Inventory) - QIDS (Quick Inventory of Depressive Symptoms; self and independent assessment) - DEQ (Depressive Experience Questionnaire) - CTQ (Child Trauma Questionnaire) - OPD SF - IIP (Inventory Interpersonal Problems) - SCL-90-R (Symptom Checklist) - WAI (Work Ability Index) - Trauma diary - Trauma memory narrative fMRI - Resting state - different modalities to measure neuroplasticity by perfusion imaging (cortical thickness, diffusion) T1 (1 year after start of intervention) Interviews: - LIFE by independent interviewer - Global Assessment Scale (GAS) Questionnaires: - BDI (Beck Depression Inventory) - QIDS (Quick Inventory of Depressive Symptoms; self and independent assessment) - DEQ (Depressive Experience Questionnaire) - CTQ (Child Trauma Questionnaire) - OPD SF - IIP (Inventory Interpersonal Problems) - SCL-90-R (Symptom Checklist) - WAI (Work Ability Index) - Trauma diary - Trauma memory narrative fMRI - Resting state - different modalities to measure neuroplasticity | — |
Countries
Germany, Switzerland, United States
Contacts
Public ContactTamara Fischmann
International Psychoanalytic University
Outcome results
None listed