Efficacy and Feasibility of a Personalized Treatment for Depression With Co-Occurring Anxiety
Condition: Depression; Anxiety
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      This study will examine the feasibility and efficacy of a personalized psychotherapy
      treatment for people with depression and co-occurring anxiety.
    

Detailed description: 
      Approximately one half of all depressed psychiatric patients also meet the criteria for an
      anxiety disorder. Compared to people with only depression, people with both depression and
      panic features experience poorer psychological and social functioning, a greater risk of
      suicide, less response to medication and therapy treatment, and a greater risk of recurring
      symptoms. Because people with depression and co-occurring anxiety features do not achieve
      full symptom remission with either medication or therapy alone, this study will use a
      treatment that combines the two. A commonly used type of depression medication called a
      selective serotonin reuptake inhibitor (SSRI) will be combined with a specialized therapy
      developed to address depression with co-occurring symptoms of panic, anxiety, and avoidance.
      This study will also test a computer-based method of assessing mood and anxiety symptom
      profiles and outcomes to determine whether participants find this method acceptable and
      clinicians find it useful.

      Participation in this study will last 20 weeks, with follow-up visits occurring 4 and 8
      months after starting. Participants will be randomly assigned to receive either an
      individualized therapy for depression and anxiety, called interpersonal psychotherapy for
      depression with panic and anxiety symptoms (IPT-PS), or a standard therapy for depression,
      called brief supportive psychotherapy (BSP). All participants will complete up to 16 therapy
      sessions and receive a standard SSRI treatment with the medication citalopram hydrobromide.
      During the IPT-PS treatment, a study therapist will examine regular computer updates of
      depression and anxiety scores for participants and talk to them about identifying and
      addressing life stressors that trigger symptoms. During the BSP treatment, a study therapist
      will encourage participants to arrive at their own solutions by emphasizing the participants'
      strengths and examining what has worked in the past.

      Participants will complete assessments weekly during the 20 weeks of the study intervention
      and at 4- and 8-month follow-up visits. These assessments will include self-report
      questionnaires about symptoms, medication side effects, and treatment adherence; vital sign
      and weight measurements; and a clinical interview. Regular assessments of medication
      effectiveness and side effects will occur every 1 to 4 weeks. Starting at the second study
      visit, participants will also complete monthly computer-based questionnaires about depression
      and anxiety symptoms.
    

Intervention name(s): Interpersonal Psychotherapy for Depression with Panic and Anxiety Symptoms (IPT-PS); Brief Supportive Psychotherapy (BSP); Citalopram hydrobromide
Intervention type(s): Behavioral; Behavioral; Drug
Intervention description(s): 16 weekly IPT-PS sessions, each lasting approximately 45 minutes; 16 weekly BPS sessions, each lasting approximately 45 minutes; A 20-week regimen of citalopram hydrobromide monotherapy on a flexible dosing schedule ranging from 10 to 60 mg/day
Other intervention name(s): Celexa
Intervention MeSH terms: Dexetimide; Citalopram; Escitalopram
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Interpersonal Psychotherapy