Cognitive Therapy for Unipolar Depression: Efficacy of a Dilemma-Focused Intervention
Condition: Major Depressive Disorder; Dysthymic Disorder
MeSH terms: Depression; Depressive Disorder; Depressive Disorder, Major; Dysthymic Disorder
Study type: Interventional

Summary: 
      The purpose of this study is to determine the efficacy of a brief psychological intervention
      focused on the personal dilemmas identified for each depressive patient. For that, this
      intervention is combined to group cognitive therapy (an already proven efficacious format)
      and compared to cognitive individual therapy.
    

Detailed description: 
      Depression is one of the more severe and serious health problems because of its morbidity,
      disabling effects and for its societal and economic burden. Despite the variety of existing
      pharmacological and psychological treatments most of the cases evolve with only partial
      remission, relapse and recurrence.

      Cognitive models made a significant contribution in the understanding of unipolar depression
      and its psychological treatment. Even though, success is only partial and many authors affirm
      the need to improve those models and also the treatment programs derived from them. One of
      the issues that requires further elaboration is the difficulty these patients experience in
      responding to treatment and in maintaining therapeutic gains across time without relapse or
      recurrence.

      Our research group has been working in the notion of cognitive conflict viewed as personal
      dilemma according to personal construct theory. The investigators use a novel method for
      identifying those conflicts using the repertory grid technique. Preliminary results with
      depressive patients show that more than 90% of them have one or more of those conflicts. This
      fact might explain the blockage and the difficult progress of these patients, especially the
      more severe and/or chronic. These results justify the need for specific interventions focused
      in the resolution of these internal conflicts.

      This study aims to empirically test the hypothesis that an intervention focused on the
      dilemma(s) specifically detected for each patient will contribute to enhance the efficacy of
      Cognitive-Behavioral Therapy for depression. A therapy manual for this approach will be
      tested using a randomized clinical trial by comparing the outcome of two treatment
      conditions: a CBT treatment package and another package combining cognitive-behavioral and
      dilemma-focused interventions. The investigators expect that this combined package will
      increase the efficacy of CBT, one of the more prestigious therapies for depression, this
      resulting in a significant contribution for its treatment.
    

Intervention name(s): Combined Cognitive Behavioral and Dilemma-Focused Therapy; Cognitive Behavioral Therapy for Depression
Intervention type(s): Behavioral; Behavioral
Intervention description(s): 7 2-hour sessions of Group Cognitive Behavioral Therapy for Depression + 8 individual sessions of a Dilemma-Focused Intervention + 1 3-hour final group session. Manualized.; Cognitive Behavioral Therapy for Depression. Format: 7 2-hour sessions in group + 8 individual sessions + 1 3-hour final group session. Manualized.
Other intervention name(s): Personal Construct Therapy; Cognitive Therapy
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Major Depressive Disorder; Dysthymic Disorder; Depression; Cognitive Behavior Therapy; Personal Construct Theory; Repertory Grid Technique; Cognitive Conflicts; Personal dilemmas