Please select the eligibility criteria that correspond to the clinical trial below.
Title: Short-term, Intensive Psychodynamic Group Therapy Versus Cognitive-behavioral Group Therapy in the Day Treatment of Anxiety Disorders and Comorbid Depressive or Personality Disorders
Brief Summary: Background: Psychodynamic and cognitive-behavioral group therapies are frequently applied in day hospitals in the treatment of anxiety disorders, and comorbid depressive or personality disorders in Poland. There is not enough evidence for its effectiveness in this environment. This study addresses this gap. The aim is to determine the effectiveness of the two kinds of day treatments consisting of intensive, short-term group therapy: psychodynamic and cognitive-behavioral for patients with anxiety disorders and comorbid depressive or personality disorders. Our objectives are: 1) Demonstrating effectiveness of each treatment in a day care setting relative to wait-list control; 2) Demonstrating the relative short- and long-term effectiveness of the two active treatments; 3) Preliminary examination of predictors and moderators of treatment response; and 4) Preliminary examination of mediators of therapeutic change; 5) Detailed comparison of impact of both methods of treatment on the outcome of used measures.

Methods/design: In this randomized controlled trial, a total of 123 patients with anxiety disorders and comorbid depressive or personality disorders will be assigned to one of three conditions: 1) psychodynamic group therapy; 2) cognitive-behavioral group therapy; 3) waiting list (control group). Therapy will last 12 weeks. Both treatments will be manualized (manuals will address comorbidity). Primary outcome measures are include self-report symptoms of anxiety, observer rated symptoms of anxiety, global improvement and dichotomized diagnosis of anxiety disorder. Secondary outcome measures include personality, depression, self-esteem, defense mechanisms, beliefs about self and others, interpersonal problems, object relations, parental bonding, meta-cognition, mindfulness and quality of life: symptoms of anxiety, depression, personality, self-esteem and defense mechanisms. Measures are taken at baseline, post-treatment and 3 months following the end of the therapy.

Discussion: The randomized controlled trial format is used to compare effectiveness of intensive group cognitive-behavior therapy and intensive group psychodynamic therapy for anxiety disorders and comorbid depressive or personality disorders. The rationale is to investigate how effectively anxiety disorders and comorbid personality disorders can be treated in a day hospital typical for Polish healthcare system in 3 months treatment.


Options:
A: Inclusion Criteria:

* Current DSM-IV diagnosis of major depressive episode, as determined by Structured Clinical Interview for DSM-IV (SCID-IV)
* Primary diagnosis of MDD, based on prominence of symptoms and target for intervention (comorbid anxiety disorders, except obsessive-compulsive disorder (OCD), will not be criteria for exclusion)
* Score of at least 18 on the 17-item Hamilton Rating Scale for Depression (HAM-D17)
* Agrees to use an effective form of contraception and/or double barrier method

Exclusion Criteria:

* Previously treated for major depression with either medication or psychotherapy
* Current psychosis, dementia, eating disorder, or dissociative disorder
* History of bipolar disorder (I and II) or schizophrenia
* Alcohol or drug dependence within 3 months prior to study entry or current alcohol or drug abuse (excluding nicotine and caffeine), as assessed by medical history and urine drug screening
* Requires neuroleptic or mood stabilizer therapy in addition to depression treatment
* Presence of any acute or chronic medical disorder that could affect successful completion of the trial
* Medical contraindications that would preclude treatment with escitalopram or duloxetine
* Presence of practical issues that would likely prevent completion of the study (e.g., planned geographical relocation)
* Pregnant or breastfeeding
* Medical conditions that could prevent the safe use of MRI (e.g., pacemaker, aneurysm clips, neurostimulators, cochlear implants, metal in eyes, or other implants; steel worker)
* Medical conditions that could prevent the safe completion of a dexamethasone-corticotropin releasing factor (Dex-CRF) test (e.g., uncontrolled hypertension, significant abnormalities in EKG, anemia, known allergies against drugs)
B: Inclusion Criteria:

* Parents of patients aged 12-17 years whose child is at least 3 criteria of borderline personality disorder ( Diagnostic and Statistical Manual of Mental Disorders 5 ) .
* Talk correctly Spanish correctly.
* Coexistence with son and willingness to participate in the groups.
* Informed consent.

Exclusion Criteria:

* Mental retardation.
* Being involved in some other structured DBT family intervention.
* Parents whose children are not receiving any treatment .
* Participated in Actions for Treatment of Personality in Adolescence (ATRAPA TAI)
C: Inclusion Criteria:

* Borderline Personality Disorder
D: Inclusion Criteria:

* Current diagnosis of Axis I anxiety disorder (based on M.I.N.I.)
* Diagnosis of comorbid personality disorder (based on SCID II) or depressive disorder (based on M.I.N.I.)
* Age: 18 to 65 years
* Sufficient knowledge of the Polish language
* Written informed consent of the patient

Exclusion Criteria:

* Organic disorder
* Acute substance related disorders
* Schizophrenia, bipolar affective disorder
* Severe depression \[over 26 points in Beck Questionnaire\] or bipolar disorder.
* Dissocial personality disorder, schizotypal personality disorder
* Current suicidal ideation with a high risk of suicide
* Restriction of intellectual capacity
* Serious unstable medical problems/complications
* Concurrent psychotherapeutic treatment
* Failed treatment of CBT or psychodynamic psychotherapy for anxiety

Answer: D