Major Depressive Disorder
Conditions
Keywords
depression, community mental health, treatment, psychotherapy, mediators
Brief summary
The goal of this study is to compare supportive-expressive therapy, a type of psychodynamic psychotherapy, with cognitive therapy for the treatment of depression in community mental health consumers. Hypothesized mediators of treatment will also be examined.
Detailed description
The goal of this study is to conduct a randomized, comparative, non-inferiority clinical trial that tests the hypothesis that a widely used form of manualized dynamic psychotherapy (supportive-expressive psychodynamic therapy) is not inferior to cognitive therapy when implemented in community mental health settings for the treatment of major depressive disorder (MDD). The specific aims are (1) to conduct a randomized non-inferiority trial to compare supportive-expressive psychodynamic therapy and cognitive therapy for patients with MDD and (2) to assess the comparative effectiveness of supportive-expressive psychodynamic therapy and cognitive therapy on secondary measures of symptoms, patient functioning, and quality of life. Patient mediators of outcome will also be examined through an additional grant awarded to Paul Crits-Christoph, Ph.D. This grant was funded by the National Institutes of Mental Health - RO1MH092363-01. This grant is entitled:The mechanisms of cognitive and dynamic therapy in community settings. Recruitment will occur solely through community mental health clinics in and around Philadelphia.
Interventions
BEHAVIORALCognitive Therapy
16 sessions of cognitive therapy administered weekly by a community mental health therapist
BEHAVIORALSupportive-Expressive Psychodynamic Therapy
16 sessions of supportive-expressive psychodynamic therapy administered weekly by a community mental health therapist
Sponsors
University of Pennsylvania
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
* Confirmed diagnosis of major depressive disorder * Able to read at the 4th grade level or higher * Willingness to be randomized and participate in research
Exclusion criteria
* Current or past diagnosis of schizophrenia, seizure disorder, bipolar disorder, psychotic features, or clinically significant organic pathology * Significant suicidal risk/ideation requiring immediate referral for more intensive treatment, or specific gesture in the last 6 months * Current substance abuse or dependence requiring immediate referral to substance abuse program * Acute medical problem requiring immediate inpatient treatment * Need for referral to a partial hospitalization program
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Hamilton Rating Scale for Depression (HAM-D) | 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of Life Inventory (QOLI) | 6 months | — |
| Ways of Responding (WOR) | 2 months | — |
| Dysfunctional Attitudes Scale (DAS) | 2 months | — |
| Self-Understanding of Interpersonal Patterns Scale-Revised (SUIP-R) | 2 months | — |
| BASIS-24 | 6 months | — |
| Beck Depression Inventory - II (BDI-II) | 6 months | — |
| Medical Outcomes Study 36-Item Short Form (SF-36) | 6 months | Measure of general functionality |
| Psychological Distance Scaling Task (PDST) | 2 months | — |
Countries
United States
Outcome results
None listed