Primary Outcome Measures:
- Retention in evidence-based treatment [ Time Frame: Measured at 3 months and 1 year ] [ Designated as safety issue: No ]
- Hamilton Depression Scale (HAMD-17) [ Time Frame: Measured at baseline and at Weeks 1, 4, 8, 12, 16, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]
Secondary Outcome Measures:
- Treatment Adherence and Retention Questionnaire (TARQ) [ Time Frame: Measured at screening and at Weeks 12, 24, and 52 ] [ Designated as safety issue: No ]
- Client Satisfaction Questionnaire (CSQ) [ Time Frame: Measured at baseline and at Weeks 4, 8, 12, 16, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]
- Perceived Need for Care Questionnaire (PNCQ) [ Time Frame: Measured at baseline and at Weeks 4, 8, 12, 16, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]
- Sheehan Disability Scale (SDS) [ Time Frame: Measured at baseline and at Weeks 4, 8, 12, 16, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]
- Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) [ Time Frame: Measured at baseline and at Weeks 4, 8, 12, 16, 24, 32, 40, 48, and 52 ] [ Designated as safety issue: No ]
Major depressive disorder (MDD) prevents an individual from functioning normally, with symptoms like irritability, fatigue, and inability to feel pleasure interfering with school, work, and family life. Treating this disorder in Hispanics is particularly difficult, because they drop treatment two to three times more frequently than European Americans. Evidence suggests that depressed Hispanics prefer treatment of psychotherapy or combined psychotherapy and medication to treatment of medications alone. This study will determine whether offering depressed Hispanics a choice in their treatment option is more effective and results in a higher treatment retention than does prescribing treatment by medication only.
All participants will be randomly assigned to one of two groups for treating their depression. The first group will act as a control group, in which participants will receive 12 weeks of acute medication treatment for MDD according to the Texas Medication Algorithm (TMA). They may receive one of several anti-depressant medications according to this algorithm, including citalopram, escitalopram, paroxetine, sertraline, and others. Each participant in the second group will receive 12 weekly sessions of brief interpersonal psychotherapy (IPT-B), with the option of adding TMA-scheduled medication at any time, as part of a treatment derived in consultation with his or her therapist. Timing of study visits will also be flexible, as participants will be encouraged to continue with MDD treatments. All participants will continue to be examined for 9 months after receiving treatment for this study to determine whether they have continued in MDD treatment. Study visits, where measurements will be taken, will be at screening; at baseline; and at Weeks 4, 8, 12, 16, 24, 32, 40, 48, and 52. All participants will be assessed through clinical interviews and self-report measures for depression symptoms, adherence to treatment, cultural orientation, discrimination and stigma related to treatment, and satisfaction with treatment.
Purpose
