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Cognitive Therapy Versus Medication Treatment for Preventing Depression Relapse

This study is currently recruiting participants.
Information provided by National Institute of Mental Health (NIMH)

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Descriptive Information Fields
Brief Title  Cognitive Therapy Versus Medication Treatment for Preventing Depression Relapse
Official Title  Are CT's Effects Durable?
Brief Summary

This study will evaluate the longer term effectiveness of cognitive therapy (CT) versus medication treatment or placebo for prevention of recurrence of depression for 24 months after termination of continuation phase therapy.

Detailed Description

Depression is a serious medical illness that is often difficult to diagnose and treat. It often recurs more than once in a person's lifetime. Effective treatment methods are needed to prevent the relapse in people who have had prior episodes of depression. CT is a short-term talking therapy that focuses on changing negative thinking patterns and helping patients develop coping skills to deal with their experiences. Evidence suggests that CT is effective in treating a number of psychiatric conditions, including anxiety and anger. This study will determine the effectiveness of booster sessions of CT versus antidepressant medication in preventing relapse of depression in people at risk for recurrent depression.

All participants in this double blind study will first receive 16 to 20 sessions of cognitive-behavioral therapy over 12 weeks. Participants who respond to the treatment, but do not achieve full remission of depressive symptoms, will be considered to be at risk for relapse. They will be randomly assigned to receive 10 booster sessions of one of three treatments over 8 months: cognitive-behavioral therapy, fluoxetine, or placebo. The booster sessions will take place twice monthly for the first 2 months and once monthly for the next 6 months. All participants who complete the entire 8 months of the study will be followed-up for an additional 2 years to monitor depressive relapse and psychosocial functioning.

Study Phase
Study Type  Interventional
Study Design  Treatment, Randomized, Double Blind (Subject, Outcomes Assessor), Placebo Control, Parallel Assignment, Efficacy Study
Primary Outcome Measure  Depressive relapse [ Time Frame: Measured at Month 24 ] [ Designated as safety issue: No ]
Secondary Outcome Measure  Psychosocial functioning [ Time Frame: Measured at Month 24 ] [ Designated as safety issue: No ]
Condition  Depression
Intervention  Drug: Fluoxetine (Prozac)
Behavioral: Cognitive therapy (CT)
Drug: Placebo
MEDLINE PMIDs
Links
Recruitment Information Fields
Recruitment Status  Recruiting
Enrollment  500
Start Date  December 2003
Completion Date December 2012
Eligibility Criteria 

Inclusion Criteria:

  • Diagnosis of recurrent unipolar major depressive disorder
  • At least 2 episodes of major depression within lifetime, including present episode
  • Speaks and reads English
  • Seeking cognitive therapy treatment
  • At least one period of complete inter-episode recovery or a history of dysthymia prior to the onset of the presenting or past episodes

Exclusion Criteria:

  • Active alcohol or other substance dependence within the 6 months prior to study entry
  • Active suicidal ideation with possible intent or probable risk
  • Mood disorder due to a medical condition or substance use, bipolar disorder, schizophrenia, or schizoaffective disorder
  • Unable to stop mood altering medications
  • Concurrent medication or exclusionary medical disorders (diabetes, head injury, stroke, cancer, multiple sclerosis) that may cause depression
  • Unable to attend clinic during business hours (Monday-Thursday, 8am-5pm) twice weekly
  • Unable to complete questionnaires
  • Unsuccessful treatment after 8 weeks of cognitive therapy with a certified therapist
  • Unsuccessful treatment after 6 weeks of 40 mg of fluoxetine (Prozac)
  • Pregnant or plans to become pregnant in the next 11-12 months
Gender Both
Ages 18 Years to 70 Years
Accepts Healthy Volunteers No
Contacts ††
Contact: Marna S. Barrett, PhD     215-746-6680     msb@mail.med.upenn.edu    
Contact: Teresa Hinton     215-746-6680     hintont@mail.med.upenn.edu    
Location Countries  United States
Administrative Information Fields
NCT ID  NCT00218764
Organization ID R01 MH69618
Secondary IDs †† DSIR 83-ATSO
Study Sponsor  National Institute of Mental Health (NIMH)
Collaborators ††
Investigators 
Principal Investigator:     Michael E. Thase, MD     University of PIttsburgh School of Medicine - Western Psychiatric Institute and Clinic    
Information Provided By National Institute of Mental Health (NIMH)
Verification Date February 2008
First Received Date  September 21, 2005
Last Updated Date February 12, 2008

 †    Required WHO trial registration data element.
††   WHO trial registration data element that is required only if it exists.




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