Effectiveness of Telephone Versus Face-to-Face CBT in Treating People With Depression
Telephone Versus Face-to-Face Administration of CBT for Depression
研究概览
地位
条件
详细说明
Major depressive disorder is a common and often long-lasting disorder with 12-month prevalence rates estimated to be between 6.6% and 10.3%. Although the personal and societal costs of depression are high, it is well established that depression can be effectively treated using antidepressant medication and/or forms of psychotherapy. Several studies have found that when given a choice, about two-thirds of depressed patients prefer psychotherapy or counseling over antidepressant medication. However, a variety of barriers exist to initiating and maintaining psychotherapy. Only about 20% of all patients referred for psychotherapy actually initiate treatment, and of those who do initiate treatment, nearly half drop out before completing treatment. The use of the telephone to deliver treatment services has been recommended as a way to reduce many of the barriers associated with failure to initiate and sustain treatment. When administered over the telephone, cognitive behavioral therapy (CBT), a form of psychotherapy that teaches ways to modify thoughts and behaviors that contribute to depression, may be superior to face-to-face CBT in improving treatment adherence and reducing depressive symptoms. This study will compare the effectiveness of telephone CBT (T-CBT) versus face-to-face CBT (FtF-CBT) in treating people with depression.
Participation in this study will include 18 weeks of treatment and 12 months of follow-up. All participants will first undergo baseline assessments that will include a telephone interview and questionnaires about mood. Participants will then be assigned randomly to receive T-CBT or FtF-CBT. Participants in both groups will receive eighteen 45-minute sessions of their assigned treatment over 18 weeks. Sessions will occur twice a week for 2 weeks, once a week for 12 weeks, and once every 2 weeks for the last 4 weeks. During sessions, participants will learn ways to modify thoughts and behaviors that contribute to their depression and ways to maintain the lifestyle changes that they have made. Treatment sessions will be identical for both groups, except one group will receive sessions over the telephone and the other in-person at a study office. All participants will repeat the baseline assessments at Weeks 4, 9, 14, and 18 of treatment and Months 3, 6, 9, and 12 of follow-up.
研究类型
注册 (实际的)
阶段
- 第三阶段
联系人和位置
学习地点
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Illinois
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Chicago、Illinois、美国、60611
- Northwestern University
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Has a current diagnosis of major depressive disorder
- Has a primary care physician at Northwestern University in Illinois, or one of a number of approved community clinics in Chicago.
- Resides in Illinois
- Has a telephone
- Speaks and reads English
Exclusion Criteria:
- Hearing, voice, or visual impairment
- Meets criteria for dementia
- Diagnosed with a psychotic disorder, bipolar disorder, dissociative disorder, current substance abuse, or other condition for which participation in a clinical trial of psychotherapy may be either inappropriate or dangerous
- Currently receiving individual psychotherapy or planning to receive psychotherapy during the treatment phase of the study
- Planning to be out of town or unavailable for treatment for 4 weeks or more during the scheduled treatment time
- Recent history of suicide attempts or is severely suicidal
- Initiated treatment with an antidepressant in the 2 months before study entry (antidepressant medication is not exclusionary)
- Depression determined to be primarily of an organic etiology
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Telephone-administered CBT
Participants will receive telephone-administered cognitive behavioral therapy.
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Over 18 weeks, participants will receive eighteen 45-minute sessions of T-CBT administered by a therapist.
Participants will undergo telephone-administered sessions twice a week for 2 weeks, once a week for 12 weeks, and once every 2 weeks for the last 4 weeks.
Participants will be taught ways to modify thoughts and behaviors that contribute to their depression and ways to maintain the lifestyle changes that they have made.
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有源比较器:Face-to-face CBT
Participants will receive face-to-face cognitive behavioral therapy.
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Over 18 weeks, participants will receive eighteen 45-minute sessions of FtF-CBT administered by a therapist.
Participants will undergo face-to-face administered sessions twice a week for 2 weeks, once a week for 12 weeks, and once every 2 weeks for the last 4 weeks.
Participants will be taught ways to modify thoughts and behaviors that contribute to their depression and ways to maintain the lifestyle changes that they have made.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Attrition (Number of Therapy Sessions Attended)
大体时间:Post treatment, up to 18 weeks
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Number of therapy sessions attended was collected.
At the end of treatment, the total number of sessions attended by each patient was collected.
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Post treatment, up to 18 weeks
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Number of Participants Who Dropped Out of Therapy
大体时间:Post treatment, up to 18 weeks
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Using the number of therapy sessions attended, we categorized patients into:
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Post treatment, up to 18 weeks
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Patient Health Questionnaire (PHQ)-9
大体时间:Measured at baseline; Weeks 4, 9, 14, and 18; and Months 3, 6 post-treatment follow-up
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Measures depression on a 9 - item scale.
Scores range from 0-27, with 0 being no symptoms.
A difference of 5 or more points on the PHQ-9 is considered a clinically meaningful response to treatment.
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Measured at baseline; Weeks 4, 9, 14, and 18; and Months 3, 6 post-treatment follow-up
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Depression, as Assessed by Hamilton Depression Rating Scale(Ham-D)
大体时间:Measured at baseline; Weeks 4, 9, 14, and 18; and Months 3, 6, 9, and 12 of follow-up
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Ham-D indicates Hamilton Depression Rating Scale,range is 0 to 52.
A score of 0 means the best outcome with no depression symptoms reported, and a score of 52 is the worse outcome with highest level of depression reported.
A difference of 3 points on the Hamilton scale has been identified as clinically significant.
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Measured at baseline; Weeks 4, 9, 14, and 18; and Months 3, 6, 9, and 12 of follow-up
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次要结果测量
结果测量 |
大体时间 |
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Health-related Quality of Life (SF-36V), Patient Satisfaction (Satisfaction Index - Mental Health), and Therapeutic Alliance (Working Alliance Inventory - Short Form)
大体时间:Measured at baseline; Weeks 4, 9, 14, and 18; and Months 3, 6, 9, and 12 of follow-up
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Measured at baseline; Weeks 4, 9, 14, and 18; and Months 3, 6, 9, and 12 of follow-up
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合作者和调查者
调查人员
- 首席研究员:David C. Mohr, PhD、Northwestern University
出版物和有用的链接
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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