Treatment of Chronic depression (Behandeling van Chronische depressie).
Conditions
Interventions
The central idea of CBASP is that chronically depressed patients fail to recognize the connection between their behavior and interpersonal/environmental consequences. In other words, they do not grasp
2. to change their patterns of coping
3. to improve their interpersonal skills.
CBASP is highly structured, focuses on teaching social problem skills, and makes use of regular homework assignments. The main focus is on interpersonal pro
Sponsors
GGZBuitenamstel
Mentrum
PsyQ
Eligibility
Inclusion criteria
Inclusion criteria: Patients (aged 18-65) are eligible to participate if their main diagnosis is a chronic form of depression according the DSM-IV criteria: 1. a chronic depressive disorder (i.e. existing for longer than 2 years); 2. a depressive disorder superimposed on a dysthymic disorder; 3. a recurring depressive disorder which, in the past 2 years, never fully remitted between the episodes. The Mini International Neuropsychiatric Interview plus (M.I.N.I. plus), a structured diagnostic interview developed in 1990 by psychiatrists and clinicians in the United States and Europe for DSM-IV and ICD-10 psychiatric disorders, will be used to assess chronic depression (16, 17). In addition, the level of symptom severity should be moderate to severe, as expressed as a score of 22 or more on the 28-item Inventory for Depressive Symptomatology (IDS) (18).
Exclusion criteria
Exclusion criteria: Patients are excluded from the study if: 1. they suffer from one (or more) of the following disorders: a psychotic disorder, bipolar disorder, organic brain syndrome, severe substance or alcohol dependence, or a severe borderline, schizotypical, or antisocial personality disorder; 2. high risk of suicidality; 3. they do not have sufficient command of the Dutch language necessary to participate in the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measure is the reduction of depressive symptoms measured with the 28-item version of Inventory of Depressive Symptoms (IDS). The IDS is a measure of symptom severity in depression that has been used to assess acute and longer-term outcomes and has highly acceptable psychometric properties (Cronbach’s alpha = .92). The IDS self-report version will be administered at baseline, after 8, 16 and 32 weeks and at the end of the study, at 52 weeks follow-up. Patients with a symptom reduction of 50%, measured on the IDS, can be seen as responder. Remission is defined as an IDS score of 13 or less. In addition, the Quick Inventory for Depressive Symptomatology (QIDS), a shortened version of 16-items of the IDS, will be administered monthly during the study. Internal consistency is high for the QIDS (Cronbach’s alpha = .86), and the total scores were highly correlated (.96) with the total scores of the IDS. | — |
Secondary
| Measure | Time frame |
|---|---|
| To assess chronic depression and comorbid disorders at baseline and at the end of the study patients will receive a diagnostic interview using the M.I.N.I. plus. Information on demographic factors (age, gender, marital status, education, professional occupation) will be collected in the baseline interview and at the end of the study. Putative modifiers of effect are well known risk-factors for chronic depression, these are: functioning, which will be measured using the WHODAS, social contacts and social participation using the Loneliness & Affiliation Scale and the Social Participation Scale, locus of control using the Mastery Scale and psychological well being using the Psychological Well Being Scales. Physical health and diseases will be measured by the CBS questionnaire, psychological mindedness using the Lack of Psychological Mindedness (LPM) and parental relationship using the Remembered Parenting Scale (RRP). The Mood Disorder Questionnaire (MDQ) will be used to measure bipolar symptoms, number of depressive episodes in the past five years using the Life Chart, anxiety using the Beck Anxiety Inventory (BAI), alcohol dependence using the Alcohol Use Disorders Identification Test (AUDIT), recent trauma using the Brugha questionnaire and childhood trauma using the Nemesis questionnaire. Personality will be measured using the NEO-Five Factor Inventory (NEO-FFI) and working alliance using the Working Alliance questionnaire. | — |
Contacts
Public ContactJ.E. Wiersma
GGZBuitenamstel A.J. Ernststraat 887
Outcome results
None listed