A Comparison of Cognitive and Dynamic Therapy for Depression in Community Settings
A Comparison of Cognitive and Dynamic Therapy for MDD in Community Settings
The goal of this study is to compare supportive-expressive therapy, a type of psychodynamic psychotherapy, with cognitive therapy for the treatment of depression in community mental health consumers.
Hypothesized mediators of treatment will also be examined.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The goal of this study is to conduct a randomized, comparative, non-inferiority clinical trial that tests the hypothesis that a widely used form of manualized dynamic psychotherapy (supportive-expressive psychodynamic therapy) is not inferior to cognitive therapy when implemented in community mental health settings for the treatment of major depressive disorder (MDD). The specific aims are (1) to conduct a randomized non-inferiority trial to compare supportive-expressive psychodynamic therapy and cognitive therapy for patients with MDD and (2) to assess the comparative effectiveness of supportive-expressive psychodynamic therapy and cognitive therapy on secondary measures of symptoms, patient functioning, and quality of life.
Patient mediators of outcome will also be examined through an additional grant awarded to Paul Crits-Christoph, Ph.D. This grant was funded by the National Institutes of Mental Health - RO1MH092363-01. This grant is entitled:"The mechanisms of cognitive and dynamic therapy in community settings."
Recruitment will occur solely through community mental health clinics in and around Philadelphia.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19104
- University of Pennsylvania
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Confirmed diagnosis of major depressive disorder
- Able to read at the 4th grade level or higher
- Willingness to be randomized and participate in research
Exclusion Criteria:
- Current or past diagnosis of schizophrenia, seizure disorder, bipolar disorder, psychotic features, or clinically significant organic pathology
- Significant suicidal risk/ideation requiring immediate referral for more intensive treatment, or specific gesture in the last 6 months
- Current substance abuse or dependence requiring immediate referral to substance abuse program
- Acute medical problem requiring immediate inpatient treatment
- Need for referral to a partial hospitalization program
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Cognitive Therapy
|
16 sessions of cognitive therapy administered weekly by a community mental health therapist
Other Names:
|
|
Experimental: Dynamic Therapy
|
16 sessions of supportive-expressive psychodynamic therapy administered weekly by a community mental health therapist
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Hamilton Rating Scale for Depression (HAM-D)
Time Frame: 6 months
|
6 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
BASIS-24
Time Frame: 6 months
|
6 months
|
|
|
Beck Depression Inventory - II (BDI-II)
Time Frame: 6 months
|
6 months
|
|
|
Medical Outcomes Study 36-Item Short Form (SF-36)
Time Frame: 6 months
|
Measure of general functionality
|
6 months
|
|
Quality of Life Inventory (QOLI)
Time Frame: 6 months
|
6 months
|
|
|
Ways of Responding (WOR)
Time Frame: 2 months
|
2 months
|
|
|
Dysfunctional Attitudes Scale (DAS)
Time Frame: 2 months
|
2 months
|
|
|
Psychological Distance Scaling Task (PDST)
Time Frame: 2 months
|
2 months
|
|
|
Self-Understanding of Interpersonal Patterns Scale-Revised (SUIP-R)
Time Frame: 2 months
|
2 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Mary Beth Gibbons, Ph.D., University of Pennsylvania
- Principal Investigator: Paul Crits-Christoph, Ph.D., University of Pennsylvania
Publications and helpful links
General Publications
- Connolly Gibbons MB, Gallop R, Thompson D, Luther D, Crits-Christoph K, Jacobs J, Yin S, Crits-Christoph P. Comparative Effectiveness of Cognitive Therapy and Dynamic Psychotherapy for Major Depressive Disorder in a Community Mental Health Setting: A Randomized Clinical Noninferiority Trial. JAMA Psychiatry. 2016 Sep 1;73(9):904-11. doi: 10.1001/jamapsychiatry.2016.1720. Erratum In: JAMA Psychiatry. 2017 Jan 1;74(1):107.
- Connolly Gibbons MB, Mack R, Lee J, Gallop R, Thompson D, Burock D, Crits-Christoph P. Comparative effectiveness of cognitive and dynamic therapies for major depressive disorder in a community mental health setting: study protocol for a randomized non-inferiority trial. BMC Psychol. 2014 Nov 11;2(1):47. doi: 10.1186/s40359-014-0047-y. eCollection 2014.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- R01HS018440 (U.S. AHRQ Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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