- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01624402
Ecosystem Focused Therapy in Post Stroke Depression
February 5, 2019 updated by: Weill Medical College of Cornell University
Older adults who are stroke survivors can experience many challenges, including depression, cognitive dysfunction, and physical disability.
Family members and other caregivers may struggle with helping stroke survivors adjust to life after stroke.
This research study involves testing a modified form of problem-solving therapy called Ecosystem Focused Therapy (EFT) to help treat depression in older adult stroke survivors.
EFT teaches problem-solving skills to patients to help them cope with problems related to stroke and depression, alters their physical environment to accommodate new needs resulting from stroke, and helps the family or caregiver to assist in the patient's adaptation.
In addition this study will compare EFT to an education intervention to see which is more effective in treating depressed stroke survivors.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
We propose to study the efficacy of "Ecosystem Focused Therapy" (EFT) in post-stroke depression (PSD), a disorder that afflicts a large number of stroke victims and increases mortality, cognitive impairment, and disability for years after stroke.
EFT is a new, home-delivered intervention based on our integrative model of PSD, which originated from our clinical biology and treatment studies in late-life depression.
It postulates two main paths to PSD.
First, stroke and stroke-repair mechanisms contribute to metabolic changes mediating PSD.
Second, a "psychosocial storm" stemming both from the patient's sudden disability and the change in the patient's needs and family life add a biological burden to this cascade of depressogenic events.
EFT targets the "psychosocial storm" of PSD and focuses on the reciprocal interaction between the patient's abilities and the challenges of his/her "ecosystem" (family, specialized therapists).
EFT follows a structured personalization approach based on the "model of adaptive functioning", in which behavior is a function of the person's competence and the demands of the environment.
Thus, EFT continuously "calibrates the environment" to the PSD patient's competence level and targets the PSD "psychosocial storm" through five integrated components: 1) It offers an action-oriented, "new perspective" about the patient's recovery.
2) It provides an "adherence enhancement structure".
3) It offers a "problem solving structure" to the patient focusing on problems, valued by the patient, and pertinent to daily function.
4) It helps the family "reengineer its goals, involvement, and plans" to accommodate the patient's disability.
5) It "coordinates care with specialized therapists" with the goal to increase patient participation in rehabilitation and social activities.
Study Type
Interventional
Enrollment (Actual)
151
Phase
- 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 Locations
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New York
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New York, New York, United States, 10065
- New York Presbyterian Hospital
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White Plains, New York, United States, 10605
- Burke Rehabilitation Hospital
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White Plains, New York, United States, 10605
- Institute of Geriatric Psychiatry
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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
Ages Eligible for Study
50 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age 50 years and older;
- Diagnosis of unipolar major depression;
- Montgomery Asberg Depression Rating Scale score ≥ 18;
- Capacity to provide written consent for both research assessment and treatment;
- Command of English sufficient to participate in assessments and talking therapy.
Exclusion Criteria:
- Moderately severe to severe dementia (MMSE score < 20);
- Greater than mild to moderate aphasia (NIH Stroke Scale: Best Language > 1);
- Expectation to be discharged to a nursing home;
- Psychotic depression;
- Suicidal intent or plan.
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 Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Ecosystem Focused Therapy (EFT)
Ecosystem Focused Therapy (EFT) follows a structured personalization approach based on the model of adaptive functioning, in which behavior is a function of the person's competence and the demands of the environment.
|
|
Active Comparator: Education on Stroke and Depression (ESD)
Education on Stroke and Depression (ESD) is home-delivered and imparts education about depression, stroke, and the role of available treatments.
|
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Depression
Time Frame: 12 months
|
This research study involves testing a modified form of problem-solving therapy called Ecosystem Focused Therapy (EFT) in reducing depression in older adult stroke survivors.
|
12 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: George S. Alexopoulos, M.D., Weill Medical College of Cornell University
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)
March 1, 2012
Primary Completion (Actual)
January 31, 2019
Study Completion (Actual)
January 31, 2019
Study Registration Dates
First Submitted
June 18, 2012
First Submitted That Met QC Criteria
June 18, 2012
First Posted (Estimate)
June 20, 2012
Study Record Updates
Last Update Posted (Actual)
February 6, 2019
Last Update Submitted That Met QC Criteria
February 5, 2019
Last Verified
February 1, 2019
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- R01MH096685 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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