Conditions: Depression Depressive Disorder
Allocation: RANDOMIZED | Intervention model: PARALLEL
Enrollment: 491
Healthy volunteers: no

Brief summary:
This 24-week study, with a 12-month follow up period, will compare the effectiveness of antidepressant medication alone to the combination of psychotherapy and antidepressant medication in patients with chronic depression.

Detailed description:
Chronic depression affects approximately 5% of adults in the United States and is associated with significant functional impairment and high health care utilization. The combination of drug treatment and psychotherapy may be most effective in treating depression. This study will determine the effects of adjunctive psychotherapy in depressed patients who have failed to respond or have responded only partially to an initial trial medication.

Participants receive an initial trial of antidepressant medication for 8 to 12 weeks. Participants who continue to have depressive symptoms are randomly assigned to add Cognitive Behavioral Analysis System of Psychotherapy (CBASP) or supportive therapy to their medication regimens or to continue pharmacotherapy alone for an additional 12 weeks. Assessments are made at 6 and 12 months post-treatment.

Arms:
arm 1: Cognitive Behavioral System of Psychotherapy plus medication (Could be switch to or addition of escitalopram, bupropion, venlafaxine or mirtazapine) arm 2: Brief Supportive Psychotherapy plus medication (Could be switch to or addition of escitalopram, bupropion, venlafaxine or mirtazapine) arm 3: Could be switch to or addition of escitalopram, bupropion, venlafaxine or mirtazapine

Interventions: intervention 1: Brief Supportive Psychotherapy intervention 2: CBASP intervention 3: Medication Only
Intervention descriptions: intervention 1: brief supportive psychotherapy intervention 2: psychotherapy developed for chronic depression intervention 3: antidepressant medication

Protocol document: