Acceptance and Commitment Therapy Versus Cognitive Therapy for the Treatment of Major Depressive Disorder

Acceptance and Commitment Therapy vs. Cognitive Therapy for the Treatment of Major Depressive Disorder

The study will investigate the effectiveness of Cognitive Therapy and Acceptance and Commitment Therapy in a randomized controlled trial among patients with Major Depressive Disorder in routine clinical practice. Furthermore, the study will investigate whether each specific treatment approach is mediated by its proposed theoretical mechanism.

Study Overview

• Status: Completed
• Conditions: Major Depressive Disorder
• Intervention / Treatment: Behavioral: Cognitive Therapy; Behavioral: Acceptance and Commitment Therapy

Detailed Description

The current study aims at investigating the effectiveness of Cognitive Therapy and Acceptance and Commitment Therapy in a randomized controlled trial among patients with MDD in routine clinical practice. Further, the study will investigate whether each specific treatment approach is mediated by its proposed theoretical mechanism. Patients have to meet diagnostic criteria for nonpsychotic MDD as determined by the Structured Interview for DSM-IV. Each client will receive either Cognitive Therapy or Acceptance and Commitment Therapy that will last between 16 to 20 sessions. Based on previous results, it is expected that both treatment forms will prove beneficial for the patients.

• Study Type: Interventional
• Enrollment (Actual): 82
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Netherlands
  • Zaandam, Netherlands, 1500 AE
    • PsyQ

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Meeting DSM-IV criteria for MDD
2. Between the ages of 18 and 65-years-old
3. Having sufficient fluency in Dutch to complete treatment and research protocol

Exclusion Criteria:

1. DSM-IV criteria for bipolar disorder (past or present)
2. Psychotic disorders
3. Substance dependence disorders (current or within the past 6 months), or
4. Organic brain syndrome.
5. Borderline or antisocial personality disorder

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cognitive Therapy (CT)	Behavioral: Cognitive Therapy; This interventions will target: (a) behavioral dysfunction, (b) situation-specific negative thinking and cognitive distortions, and (c) underlying dysfunctional beliefs or cognitions assumed to be related to the patient's current depression and risk of future depression. A maximum of 20 45-55 minute sessions will be provided, with sessions generally held weekly for the first 8 sessions and once every two weeks for the next 8 sessions.; Other Names: Cognitive behavior therapy; cognitive behaviour therapy.
Experimental: Acceptance and Commitment Therapy (ACT)	Behavioral: Acceptance and Commitment Therapy; This interventions will use (a) acceptance, (b) commitment, (c) mindfulness, and (d) behavior change processes to produce reduction of depressive symptoms. A maximum of 20 45-55 minute sessions will be provided, with sessions generally held weekly for the first 8 sessions and once every two weeks for the next 8 sessions.; Other Names: Mindfulness-based interventions

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
QUICK INVENTORY OF DEPRESSIVE SYMPTOMATOLOGY (QIDS-SR)	Change from pre-treatment to post-treatment, 6 months follow-up and 12 months follow-up	pre-treatment, post-treatment, 6 and 12 months follow-up
Hamilton Rating Scale for Depression	Change from pre-treatment to post-treatment.	pre-treatment, post-treatment

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Decentering subscale of the Experiences Questionnaire	Change between sessions and to follow-up.	Pre-treatment, in-treatment, and 6 and 12 months follow-up.
Acceptance and Action Questionnaire	Change between sessions and to follow-up.	Pre-treatment, in-treatment, and 6 and 12 months follow-up.
Dysfunctional Attitude Scale-revised	Change between sessions to follow-up.	Pre-treatment, in-treatment, and 6 and 12 months follow-up
Working Alliance Inventory		3. session
Eurohis Quality of Life Scale	Change pre-treatment to post-treatment and to follow-up.	Pre-, post-treatment, 6 and 12 months follow-up
Relationship Scales	Change pre-treatment to post-treatment and to follow-up.	Pre-, post-treatment, 12 months follow-up
Implicit Attitude Test	Change pre-treatment to post-treatment	Pre- and posttreatment
Structured Clinical Interview for DSM-IV (Major Depression Module)	Change in diagnosis of Major Depression Disorder from pre-treatment to post-treatment.	Pre-treatment and post-treatment.

Collaborators and Investigators

• Sponsor: VU University of Amsterdam
• Investigators: Principal Investigator: Paul MG Emmelkamp, PhD, University of Amsterdam

Publications and helpful links

General Publications

• A-Tjak JGL, Morina N, Topper M, Emmelkamp PMG. One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression. BMC Psychiatry. 2021 Jan 14;21(1):41. doi: 10.1186/s12888-020-03020-1.
• A-Tjak JGL, Morina N, Boendermaker WJ, Topper M, Emmelkamp PMG. Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression. BMC Psychiatry. 2020 Apr 7;20(1):155. doi: 10.1186/s12888-020-02547-7.

Study record dates

Study Major Dates

• Study Start: December 1, 2011
• Primary Completion (Actual): August 1, 2015
• Study Completion (Actual): August 1, 2015

Study Registration Dates

• First Submitted: November 8, 2011
• First Submitted That Met QC Criteria: January 20, 2012
• First Posted (Estimate): January 25, 2012

Study Record Updates

• Last Update Posted (Actual): July 30, 2019
• Last Update Submitted That Met QC Criteria: July 26, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Mood Disorders; Depression; Depressive Disorder; Depressive Disorder, Major
• Other Study ID Numbers: METC 10/103