Evidence-Based Psychological Treatment for Emotional Disorders Attended in Dominican Primary Care Units (PsicAP) (PsicAP)

October 5, 2021 updated by: Zoilo Emilio García Batista, Pontificia Universidad Catolica Madre y Maestra

Treatment for Emotional Disorders in Primary Care Units With Evidence-Based Psychological Techniques and mHealth: A Randomized Controlled Trial

Emotional disorders affect millions of people all over the world. Thousands of Dominicans suffer from depression, anxiety, and other emotional disorders that have negative impact on their lives. Nevertheless, many of them do not receive a proper treatment. The purpose of this study is to describe a pilot project, in which a protocol of evidence-based psychological treatment for emotional disorders, supported by mHealth (mobile health), will be applied on Dominicans who attend Primary Care services. It will be a collaborative program, divided into three phases, and based on cognitive behavioral therapy. The hypothesis of this research is that this protocol is an effective strategy to treat emotional disorders.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Emotional disorders, such as anxiety, depression and somatic disorders, represent a serious public health issue. Many people who suffer from them do not have access to an adequate psychological treatment. Some of the reasons why this situation happens are: the high cost that tends to represent a proper psychological treatment, and, in countries like Dominican Republic, the lack of a protocol that guides health professionals of Primary Care Units on the diagnosis and treatment of these emotional disorders. The purpose of this study is to describe a pilot project, in which a treatment protocol for emotional disorders will be applied by trained mental health professionals in Dominican Primary Care Units. It will be a randomized controlled trial with 300 patients. To prove the effectiveness of this protocol, the phases of this study will be: 1) psychological assessment of the study sample; 2) seven sessions of conventional treatment offered to a control group, and seven sessions of the evidence-based psychological techniques, suggested by this new protocol, given to an experimental group; 3) psychological reassessment of the study sample. This protocol suggests transdiagnostic approaches and collaborative interventions, that include group-sessions and evidence-based psychological techniques derived from cognitive behavioral therapy. Also, the protocol will be supported by mHealth tools. Some of the points included in the protocol are: psychoeducation on emotional disorders symptoms, relaxation and breathing techniques, thought management, improvement of quality of life and relapse prevention.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
300

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Dominican Republic
    • Santiago
      • Santiago de los Caballeros, Santiago, Dominican Republic, 51000
        • Recruiting
        • Centro de Atención Primaria Dr. Sergio Bisonó (Barrio Lindo)
        • Contact:
        • Contact:
      • Santiago de los Caballeros, Santiago, Dominican Republic, 51000
        • Recruiting
        • Centro de Atención Primaria El Guano
        • Contact:
        • Contact:
      • Santiago de los Caballeros, Santiago, Dominican Republic, 51000
      • Santiago de los Caballeros, Santiago, Dominican Republic, 51000

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 79 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Age between 18 and 79 years old.
  • Adults with mild or moderate levels of anxiety, depression or somatic disorders.
  • Dominicans.
  • People who are not receiving any psychological treatment.
  • People who know how to read and write.

Exclusion Criteria:

  • A diagnostic of severe mental/emotional disorder.
  • Recent suicide attempt.
  • Severe disability.
  • People who do not meet sufficient criteria to be diagnosed with mental or emotional disorders.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: DOUBLE

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
EXPERIMENTAL: PsicAP protocol
The treatment of the experimental group will be according to the PsicAP protocol: seven sessions of a psychological treatment based on transdiagnostic approaches, collaborative interventions, group-sessions, and evidence-based psychological techniques derived from cognitive behavioral therapy.
Behavioral: PsicAP protocol
The intervention will include: psychoeducation, relaxation and breathing techniques, thought management, tips to improve quality of life and relapse prevention. All of these activities will be based on scientific evidence and many of these aspects will be supported by mobile devices.
Other Names:
  • Evidence-Based Psychological Techniques and mHealth
ACTIVE_COMPARATOR: Conventional treatment
The control group will have seven sessions based on the typical psychological services that currently are offered in the Dominican Primary Care Units.
Behavioral: Conventional treatment
Typical treatment that is currently given to patients with emotional disorders in Dominican primary care units.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in the score of Patient Health Questionnaire-2
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
On Patient Health Questionnaire-2 (PHQ-2), patients are asked how often, in the last two weeks, they have been bothered by depressed mood and anhedonia. Each response option is scored from 0 to 3. Therefore, total scores of the scale range from 0 to 6. A score of 3 or greater means high possibility of major depressive disorder.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Patient Health Questionnaire-4
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
On Patient Health Questionnaire-4 (PHQ-4), subjects are asked how often, in the last two weeks, they have been bothered by core symptoms/signs of depression and anxiety. This test has two subscales: one of them has two items that evaluate depression; the other one, two items that assess anxiety. Each response option is scored from 0 to 3, so total scores for each subscale range from 0 to 6. A score of 3 or greater on the depression subscale represents a high probability of this disease; a score of 3 or greater on the anxiety subscale means that the prevalence of an anxiety disorder is likely.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Patient Health Questionnaire-9
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
On Patient Health Questionnaire-9 (PHQ-9), through 9 items, subjects are asked how often, in the last two weeks, they have been bothered by core symptoms of depression. Each response option is scored from 0 to 3, so total scores range from 0 to 27. PHQ-9 scores of 5, 10, 15, and 20 represent cutpoints for mild, moderate, moderately severe, and severe depression, respectively.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Patient Health Questionnaire-15
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
On Patient Health Questionnaire-15 (PHQ-15), through 15 items, subjects are asked how often, in the last 4 weeks, they have been bothered by somatic symptoms. Each response option is scored from 0 to 2. Therefore, total scores range from 0 to 30. PHQ-15 scores of 5, 10, 15, represent cutpoints for low, medium, and high somatic symptom severity, respectively.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Patient Health Questionnaire-PD
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
The Patient Health Questionnaire-Panic Disorder (PHQ-PD) is actually a section of PHQ, which comprises 15 items (questions 3a-d and 4a-d-k are the ones that evaluate PD). There are two answer categories: "no" (0 points) and "yes" (1 point.). Therefore, total scores range from 0 to 15. In Spanish population, the best cutoff score for screening panic disorder in patients is 5.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Generalized Anxiety Disorder Test-2
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
On Generalized Anxiety Disorder Test (GAD-2), through two items, subjects are asked how often, in the last two weeks, they have been bothered by core symptoms of anxiety. Each response option of the scale is scored from 0 to 3, so total scores range from 0 to 6. GAD-2 score of 3 represent the best cutoff point for screening generalized anxiety disorder.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Generalized Anxiety Disorder Test-7
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
On Generalized Anxiety Disorder Test-7 (GAD-7), through seven items, subjects are asked how often, in the last two weeks, they have been bothered by core symptoms of generalized anxiety disorder. Each response option of the scale is scored from 0 to 3, so total scores range from 0 to 21. Scores of ≥5, ≥10, and ≥15 represent mild, moderate, and severe anxiety symptom levels, respectively.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Sheehan Disability Inventory
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
The Sheehan Disability Inventory (SDS) is a 5-item self-report tool. In the first three items, patients rate their functional impairment in work/school, social life, and family life, by a 10-point visual analog scale in each case. Scores of ≥5 on any of the three scales are associated with significant functional impairment. The last two items evaluate the amount of days lost or unproductive due to the functional impairment.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of the Brooding subscale from Ruminative Responses Scale (RRS)
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
The Ruminative Responses Scale (RRS) has 22 items. Patients must indicate what they generally do when they feel down, sad, or depressed, using a 4-point Likert-type scale representing frequency (1=never; 4=always). The brooding subscale is composed by 5 of the 22 items of the whole scale. Therefore, total scores of this subscale range from 5 to 20. Higher scores on this subscale indicate significant levels of brooding.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of the Penn State Worry Questionnaire (PSWQ)
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
The Penn State Worry Questionnaire (PSWQ) is a 16-item questionnaire. Items are rated using a 5-point Likert-scale (from 1="not at all typical of me" to 5="very typical of me"). Therefore, total scores range from 16 to 80. Scores of ≥16, ≥40, and ≥60 represent low, moderate, and high worry levels, respectively.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Inventory of Cognitive Activity in Anxiety Disorders
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
Inventory of Cognitive Activity in Anxiety Disorders (IACTA; Inventario de Actividad Cognitiva en los Trastornos de Ansiedad) is an instrument that evaluates certain cognitive activity in patients with different types of anxiety disorders. It has three subscales: panic attack (14 items), agoraphobia (14 items), and social phobia (20 items). Subjects are asked to indicate how often they pay attention to certain cognitive distortions about symptoms related to those disorders, ranging from 0 (almost never) to 4 (almost always). Higher the scores, higher the probability of suffering from a type of anxiety disorder. A cutoff point of 48 on panic attack and agoraphobia subscales was related to the prevalence of panic disorder; a cutoff point of social phobia subscale was related to suffering from social phobia disorder.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Questionnaire of Cognitive Distorsions in Emotional Disorders
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
Questionnaire of Cognitive Distorsions in Emotional Disorders (CDTE; Cuestionario de Distorsiones Cognitivas en los Trastornos Emocionales) is an instrument that evaluates the frequency with which certain cognitive distortions appear. It has 52 items. Each response option of the scale is scored from 0 (almost never) to 4 (almost always). Therefore, total scores range from 0 to 208. Higher scores indicate greater levels of cognitive distortions.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Emotion Regulation Questionnaire (ERQ)
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
Emotion Regulation Questionnaire (ERQ) is a 10-item scale that measures patients' tendency to regulate their emotions in two ways: cognitive reappraisal and expressive suppression. Each response option is scored by a 7-point Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree). Therefore, total scores range from 10 to 70. The higher the score, the greater the use of emotion regulation strategies.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of Metacognitions Questionnaire (MCQ-30)
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
Metacognitions Questionnaire (MCQ-30) measures individual differences in meta-cognitive beliefs, judgments and monitoring tendencies. It comprises a total of 30 items. Responses to each item are based on a 4-point Likert scale (from 1 = "do not agree" to 4 = "strongly agree"). MCQ-30 scores range from 30 to 120 points. Higher scores indicate greater pathological meta-cognitive activity.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of World Health Organization Quality of Life - BREF (WHOQOL-BREF)
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
The World Health Organization Quality of Life - BREF (WHOQOL-BREF) is a self-report questionnaire that evaluates four domains of quality of life (QOL): physical health, psychological health, social relationships, and environment. In addition, there are two items that measure overall QOL and general health. The whole scale is formed by 26 items. Subjects have to answer according to how they have been feeling in the last two weeks. Responses to each item are based on a 5-point Likert scale (from 1 = "not at all" to 5 = "completely"). The raw score ranges of each domain are: 7-35 for physical health, 6-30 for psychological health, 3-15 for social relationships, and 8-40 for environment. Higher scores denote higher quality of life.
An average of 16 months (from baseline to psychological treatment completion).
Change in the score of EuroQol-5 D (EQ-5D)
Time Frame: An average of 16 months (from baseline to psychological treatment completion).
EuroQoL is an instrument that measure the quality of life related to health. It has two main parts. The first part is a descriptive system in which subjects indicate how they feel, during the current day of the assessment, in the following areas of their lives: movement ability, personal care, daily activities, pain and anxiety/depression. Responses to each item are based on three options: 1 (no problems), 2 (some/moderate problems), 3 (many problems). Higher scores on these items denote worse quality of life. The second part is a visual analog scale in which subjects must indicate how they evaluate their health condition during the current day of the evaluation (from 0=the worst health condition, to 100=the best health condition).
An average of 16 months (from baseline to psychological treatment completion).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Pontificia Universidad Catolica Madre y Maestra

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Ministerio de Educación Superior, Ciencia y Tecnología, Dominican Republic

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Zoilo E García Batista, PhD, Pontificia Universidad Catolica Madre y Maestra
  • Study Chair: Kiero Guerra Peña, PhD, Pontificia Universidad Catolica Madre y Maestra
  • Study Chair: Antonio Cano-Vindel, PhD, Universidad Complutense de Madrid
  • Study Chair: Ricardo Araya, PhD, King's College London

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Cano Vindel A. Bases teóricas y apoyo empírico de la intervención psicológica sobre los desórdenes emocionales en Atención Primaria. Una actualización. Ansiedad y estrés. 2011; 17(2-3): 157-184.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 9, 2021

Primary Completion (ANTICIPATED)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 1, 2023

Study Completion (ANTICIPATED)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 1, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 12, 2020

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 18, 2020

First Posted (ACTUAL)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 24, 2020

Study Record Updates

Last Update Posted (ACTUAL)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
October 7, 2021

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 5, 2021

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2018-2019-2A1-96

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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