Research Evaluating the Value of Augmenting Medication With Psychotherapy

NCT ID: NCT00057551

Last Updated: 2017-12-06

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

491 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-04-30

Study Completion Date

2007-03-31

Brief Summary

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This 24-week study, with a 12-month follow up period, will compare the effectiveness of antidepressant medication alone to the combination of psychotherapy and antidepressant medication in patients with chronic depression.

Detailed Description

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Chronic depression affects approximately 5% of adults in the United States and is associated with significant functional impairment and high health care utilization. The combination of drug treatment and psychotherapy may be most effective in treating depression. This study will determine the effects of adjunctive psychotherapy in depressed patients who have failed to respond or have responded only partially to an initial trial medication.

Participants receive an initial trial of antidepressant medication for 8 to 12 weeks. Participants who continue to have depressive symptoms are randomly assigned to add Cognitive Behavioral Analysis System of Psychotherapy (CBASP) or supportive therapy to their medication regimens or to continue pharmacotherapy alone for an additional 12 weeks. Assessments are made at 6 and 12 months post-treatment.

Conditions

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Depression Depressive Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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CBASP

Cognitive Behavioral System of Psychotherapy plus medication (Could be switch to or addition of escitalopram, bupropion, venlafaxine or mirtazapine)

Group Type EXPERIMENTAL

CBASP

Intervention Type BEHAVIORAL

psychotherapy developed for chronic depression

Brief Supportive Psychotherapy

Brief Supportive Psychotherapy plus medication (Could be switch to or addition of escitalopram, bupropion, venlafaxine or mirtazapine)

Group Type ACTIVE_COMPARATOR

Brief Supportive Psychotherapy

Intervention Type BEHAVIORAL

brief supportive psychotherapy

Medication Only

Could be switch to or addition of escitalopram, bupropion, venlafaxine or mirtazapine

Group Type ACTIVE_COMPARATOR

Medication Only

Intervention Type DRUG

antidepressant medication

Interventions

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Brief Supportive Psychotherapy

brief supportive psychotherapy

Intervention Type BEHAVIORAL

CBASP

psychotherapy developed for chronic depression

Intervention Type BEHAVIORAL

Medication Only

antidepressant medication

Intervention Type DRUG

Other Intervention Names

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Cognitive Behavioral Analysis System of Psychotherapy one of five antidepressants

Eligibility Criteria

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Inclusion Criteria

* Major depressive episode
* Depressive symptoms \> 2 years without remission
* Hamilton Depression Scale (HAM-D) score \> 20
* Fluent in English

Exclusion Criteria

* Psychotic disorders, bipolar disorder, post traumatic stress disorder, obsessive compulsive disorder, or eating disorder
* Serious, unstable, or terminal medical condition
* Axis II diagnosis of antisocial, schizotypal, or severe borderline personality disorder
* Previous treatment with CBASP
* Previous ineffective treatment with 4 of the medication treatments used in the study
* Substance abuse
* Pregnancy
* Not willing to end other psychiatric treatment
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Weill Medical College of Cornell University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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James H Kocsis

Role: PRINCIPAL_INVESTIGATOR

weill cornell mc

Locations

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Emory University

Atlanta, Georgia, United States

Site Status

Weill-Cornell Medical College Payne Whitney Clinic

New York, New York, United States

Site Status

SUNY- Stony Brook

New York, New York, United States

Site Status

University of Pittsburgh

Pittsburgh, Pennsylvania, United States

Site Status

Brown University

Providence, Rhode Island, United States

Site Status

University of Arizona

Tucson, Arizona, United States

Site Status

Stanford University

Palo Alto, California, United States

Site Status

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status

Countries

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United States

References

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Keller MB, McCullough JP, Klein DN, Arnow B, Dunner DL, Gelenberg AJ, Markowitz JC, Nemeroff CB, Russell JM, Thase ME, Trivedi MH, Zajecka J. A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med. 2000 May 18;342(20):1462-70. doi: 10.1056/NEJM200005183422001.

Reference Type BACKGROUND
PMID: 10816183 (View on PubMed)

Keller MB, Kocsis JH, Thase ME, Gelenberg AJ, Rush AJ, Koran L, Schatzberg A, Russell J, Hirschfeld R, Klein D, McCullough JP, Fawcett JA, Kornstein S, LaVange L, Harrison W. Maintenance phase efficacy of sertraline for chronic depression: a randomized controlled trial. JAMA. 1998 Nov 18;280(19):1665-72. doi: 10.1001/jama.280.19.1665.

Reference Type BACKGROUND
PMID: 9831997 (View on PubMed)

McCullough JP Jr. Treatment for chronic depression using Cognitive Behavioral Analysis System of Psychotherapy (CBASP). J Clin Psychol. 2003 Aug;59(8):833-46. doi: 10.1002/jclp.10176.

Reference Type BACKGROUND
PMID: 12858425 (View on PubMed)

Shankman SA, Gorka SM, Katz AC, Klein DN, Markowitz JC, Arnow BA, Manber R, Rothbaum BO, Thase ME, Schatzberg AF, Keller MB, Trivedi MH, Kocsis JH. Side Effects to Antidepressant Treatment in Patients With Depression and Comorbid Panic Disorder. J Clin Psychiatry. 2017 Apr;78(4):433-440. doi: 10.4088/JCP.15m10370.

Reference Type DERIVED
PMID: 28068460 (View on PubMed)

Shankman SA, Campbell ML, Klein DN, Leon AC, Arnow BA, Manber R, Keller MB, Markowitz JC, Rothbaum BO, Thase ME, Kocsis JH. Dysfunctional attitudes as a moderator of pharmacotherapy and psychotherapy for chronic depression. J Psychiatr Res. 2013 Jan;47(1):113-21. doi: 10.1016/j.jpsychires.2012.09.018. Epub 2012 Oct 25.

Reference Type DERIVED
PMID: 23102821 (View on PubMed)

Klein DN, Leon AC, Li C, D'Zurilla TJ, Black SR, Vivian D, Dowling F, Arnow BA, Manber R, Markowitz JC, Kocsis JH. Social problem solving and depressive symptoms over time: a randomized clinical trial of cognitive-behavioral analysis system of psychotherapy, brief supportive psychotherapy, and pharmacotherapy. J Consult Clin Psychol. 2011 Jun;79(3):342-52. doi: 10.1037/a0023208.

Reference Type DERIVED
PMID: 21500885 (View on PubMed)

Kocsis JH, Gelenberg AJ, Rothbaum BO, Klein DN, Trivedi MH, Manber R, Keller MB, Leon AC, Wisniewski SR, Arnow BA, Markowitz JC, Thase ME; REVAMP Investigators. Cognitive behavioral analysis system of psychotherapy and brief supportive psychotherapy for augmentation of antidepressant nonresponse in chronic depression: the REVAMP Trial. Arch Gen Psychiatry. 2009 Nov;66(11):1178-88. doi: 10.1001/archgenpsychiatry.2009.144.

Reference Type DERIVED
PMID: 19884606 (View on PubMed)

Other Identifiers

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U01MH062475

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH061504

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH061562

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH061587

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH061590

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH062465

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH062491

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH062546

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH063481

Identifier Type: NIH

Identifier Source: secondary_id

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U01MH062475

Identifier Type: NIH

Identifier Source: org_study_id

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