Chronic Depression
Conditions
Keywords
chronic depression, CBASP, Escitalopram, depression, trauma
Brief summary
60 patients with chronic major depressive disorder according to DSM-IV will be included into the study. Patients will be randomized to receive an open treatment either with CBASP, a psychotherapy for chronic depression, or pharmacological treatment with Escitalopram for 28 weeks.
Detailed description
The psychotherapeutic treatment with CBASP will be conducted in 2 weekly sessions for the first 4 weeks, one per week thereafter until week 9, followed by one session every 2 weeks for 20 more weeks. The starting dose for Escitalopram will be 10 mg/d for one week and will be increased to 20 mg/d after one week. The dosage can be reduced to 10 mg/d after day 7 to improve tolerance. Th MADRS-scale is the primary outcome measure; ratings will be performed by a blinded rater. If there is no improvement (reduction of less than 20% of the MADRS), patients will be crossed over in terms of adding the other treatment at week 8. Study patients will be asked to participate in fMRI, genetic and pharmacological substudies.
Interventions
OTHERCBASP psychotherapy
specific psychotherapy for chronic depression
DRUGEscitalopram
Escitalopram 10-20 mg once daily for the treatment of depression in combination with clinical management
Sponsors
University Hospital, Bonn
University Hospital Freiburg
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Chronic MDD according to DSM-IV (modification: depressive symptomatology for at least one year), or recurrent MDE (third or greater episode with the immediately preceding episode being no more than 2.5 years before the onset of the present episode) * Age 18-65 * Score of at least 18 on the Montgomery-Asberg-Rating Scale for Depression (MADRS)
Exclusion criteria
* Acute risk for suicide * History of psychotic symptoms, bipolar disorder or dementia * Severe substance-related abuse or dependence disorder * Schizotypal, antisocial or borderline personality disorder * Serious medical condition * Severe cognitive impairment * Absence of a response to previous adequate trial of the study medication/CBASP * Hypersensitivity to Escitalopram * Treatment with a MAO-inhibitor within 1 week before the initiation of study treatment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Depressive symptomatology after 8 weeks after randomization as measured by the MADRS | 8 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Depressive symptoms and remission 28 weeks after randomization; social, interpersonal and work function 28 weeks after randomization | 28 weeks after ranomization |
Countries
Germany
Outcome results
None listed