Cognitive Therapy for Recurrent Depression

NCT ID: NCT00118404

Last Updated: 2014-06-05

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

523 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-03-31

Study Completion Date

2008-07-31

Brief Summary

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This study determined the effectiveness of continuation phase cognitive therapy versus antidepressant medication in preventing relapse of depression in people with recurrent depression.

Detailed Description

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Cognitive therapy (CT) is a short-term talking therapy that focuses on changing negative thinking patterns and helping patients develop coping skills to deal with their experiences. Evidence suggests that CT is effective in treating a number of psychiatric conditions, including anxiety and anger. This study will determine the effectiveness of cognitive therapy versus antidepressant medication or placebo in preventing relapse of depression in people with recurrent depression.

This study lasted approximately 36 months and comprised three phases. For the first 12 weeks, all participants received between 16 and 20 CT sessions. Participants were then randomly assigned to receive additional CT sessions, antidepressants, or placebo for an additional 8 months. Upon completing treatment, participants entered follow-up study visits once every 4 months for the next 24 months. Clinician-rated scales and questionnaires were used to assess depressive symptoms of participants at study start and at the end of each study phase.

Conditions

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Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1

Participants received acute phase and continuation phase cognitive therapy

Group Type EXPERIMENTAL

Continuation phase cognitive therapy

Intervention Type BEHAVIORAL

Continuation phase cognitive therapy included 10 sessions over 8 months.

Acute phase cognitive therapy

Intervention Type BEHAVIORAL

For the first 12 weeks, all participants received between 16 and 20 cognitive therapy sessions.

2

Participants received acute phase cognitive therapy and continuation phase pill placebo

Group Type PLACEBO_COMPARATOR

Continuation phase pill placebo

Intervention Type OTHER

The dosage of pill placebo was increased to 40 mg over 8 months.

Acute phase cognitive therapy

Intervention Type BEHAVIORAL

For the first 12 weeks, all participants received between 16 and 20 cognitive therapy sessions.

3

Participants received acute phase cognitive therapy and continuation phase fluoxetine

Group Type ACTIVE_COMPARATOR

Continuation phase fluoxetine

Intervention Type DRUG

The dosage of fluoxetine was increased to 40 mg over 8 months.

Acute phase cognitive therapy

Intervention Type BEHAVIORAL

For the first 12 weeks, all participants received between 16 and 20 cognitive therapy sessions.

Interventions

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Continuation phase cognitive therapy

Continuation phase cognitive therapy included 10 sessions over 8 months.

Intervention Type BEHAVIORAL

Continuation phase fluoxetine

The dosage of fluoxetine was increased to 40 mg over 8 months.

Intervention Type DRUG

Continuation phase pill placebo

The dosage of pill placebo was increased to 40 mg over 8 months.

Intervention Type OTHER

Acute phase cognitive therapy

For the first 12 weeks, all participants received between 16 and 20 cognitive therapy sessions.

Intervention Type BEHAVIORAL

Other Intervention Names

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Prozac

Eligibility Criteria

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Inclusion Criteria

* Recurrent unipolar major depressive disorder
* Have experienced at least two episodes of major depression
* Have experienced at least one period of recovery during a depressive episode or have a history of dysthymia (a mood disorder characterized by depression) prior to the onset of current or past depressive episodes
* Willing and able to comply with all study requirements
* Able to speak and read English

Exclusion Criteria

* Active alcohol or other substance dependence within 6 months prior to study entry
* Currently at risk for suicide
* Mood disorders due to a medical condition or substance abuse
* Bipolar, schizoaffective, obsessive compulsive, or eating disorders
* Schizophrenia
* Unable to stop mood-altering medications
* Current use of medication or diagnosis of a medical disorder that may cause depression (e.g., diabetes, head injury, stroke, cancer, multiple sclerosis)
* Previous failure to experience a reduction in depressive symptoms after 8 weeks of cognitive therapy with a certified therapist
* Previous failure to experience a reduction in depressive symptoms after 6 weeks of 40 mg of Prozac
* Pregnancy or plan to become pregnant in the next 11-12 months
* Unable to attend clinic twice weekly during business hours
* Unable to complete questionnaires
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

University of Texas Southwestern Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Robin Jarrett

Professor of Psychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Robin B. Jarrett, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Texas, Southwestern Medical Center at Dallas

Locations

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University of Pittsburgh Medical Center Western Psychiatric Institute and Clinic

Pittsburgh, Pennsylvania, United States

Site Status

University of Texas Southwestern Medical Center at Dallas

Dallas, Texas, United States

Site Status

Countries

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United States

References

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Jarrett RB, Thase ME. Comparative efficacy and durability of continuation phase cognitive therapy for preventing recurrent depression: design of a double-blinded, fluoxetine- and pill placebo-controlled, randomized trial with 2-year follow-up. Contemp Clin Trials. 2010 Jul;31(4):355-77. doi: 10.1016/j.cct.2010.04.004. Epub 2010 May 6.

Reference Type BACKGROUND
PMID: 20451668 (View on PubMed)

Jarrett RB, Vittengl JR, Clark LA, Thase ME. Skills of Cognitive Therapy (SoCT): a new measure of patients' comprehension and use. Psychol Assess. 2011 Sep;23(3):578-86. doi: 10.1037/a0022485.

Reference Type RESULT
PMID: 21319902 (View on PubMed)

Dunn TW, Vittengl JR, Clark LA, Carmody T, Thase ME, Jarrett RB. Change in psychosocial functioning and depressive symptoms during acute-phase cognitive therapy for depression. Psychol Med. 2012 Feb;42(2):317-26. doi: 10.1017/S0033291711001279. Epub 2011 Jul 25.

Reference Type RESULT
PMID: 21781377 (View on PubMed)

Smits JA, Minhajuddin A, Thase ME, Jarrett RB. Outcomes of acute phase cognitive therapy in outpatients with anxious versus nonanxious depression. Psychother Psychosom. 2012;81(3):153-60. doi: 10.1159/000334909. Epub 2012 Mar 3.

Reference Type RESULT
PMID: 22398963 (View on PubMed)

Renner F, Jarrett RB, Vittengl JR, Barrett MS, Clark LA, Thase ME. Interpersonal problems as predictors of therapeutic alliance and symptom improvement in cognitive therapy for depression. J Affect Disord. 2012 May;138(3):458-67. doi: 10.1016/j.jad.2011.12.044. Epub 2012 Feb 4.

Reference Type RESULT
PMID: 22306232 (View on PubMed)

Jarrett RB, Minhajuddin A, Borman PD, Dunlap L, Segal ZV, Kidner CL, Friedman ES, Thase ME. Cognitive reactivity, dysfunctional attitudes, and depressive relapse and recurrence in cognitive therapy responders. Behav Res Ther. 2012 May;50(5):280-6. doi: 10.1016/j.brat.2012.01.008. Epub 2012 Feb 21.

Reference Type RESULT
PMID: 22445946 (View on PubMed)

Brandon AR, Minhajuddin A, Thase ME, Jarrett RB. Impact of reproductive status and age on response of depressed women to cognitive therapy. J Womens Health (Larchmt). 2013 Jan;22(1):58-66. doi: 10.1089/jwh.2011.3427.

Reference Type RESULT
PMID: 23305218 (View on PubMed)

Jarrett RB, Minhajuddin A, Kangas JL, Friedman ES, Callan JA, Thase ME. Acute phase cognitive therapy for recurrent major depressive disorder: who drops out and how much do patient skills influence response? Behav Res Ther. 2013 May;51(4-5):221-30. doi: 10.1016/j.brat.2013.01.006.

Reference Type RESULT
PMID: 23485420 (View on PubMed)

Jarrett RB, Minhajuddin A, Gershenfeld H, Friedman ES, Thase ME. Preventing depressive relapse and recurrence in higher-risk cognitive therapy responders: a randomized trial of continuation phase cognitive therapy, fluoxetine, or matched pill placebo. JAMA Psychiatry. 2013 Nov;70(11):1152-60. doi: 10.1001/jamapsychiatry.2013.1969.

Reference Type RESULT
PMID: 24005123 (View on PubMed)

Vittengl JR, Clark LA, Thase ME, Jarrett RB. Nomothetic and idiographic symptom change trajectories in acute-phase cognitive therapy for recurrent depression. J Consult Clin Psychol. 2013 Aug;81(4):615-26. doi: 10.1037/a0032879. Epub 2013 Apr 29.

Reference Type RESULT
PMID: 23627652 (View on PubMed)

Vittengl JR, Clark LA, Thase ME, Jarrett RB. Replication and extension: separate personality traits from states to predict depression. J Pers Disord. 2014 Apr;28(2):225-46. doi: 10.1521/pedi_2013_27_117. Epub 2013 Jun 20.

Reference Type RESULT
PMID: 23786268 (View on PubMed)

Callan JA, Kazantzis N, Park SY, Moore CG, Thase ME, Minhajuddin A, Kornblith S, Siegle GJ. A Propensity Score Analysis of Homework Adherence-Outcome Relations in Cognitive Behavioral Therapy for Depression. Behav Ther. 2019 Mar;50(2):285-299. doi: 10.1016/j.beth.2018.05.010. Epub 2018 Jun 5.

Reference Type DERIVED
PMID: 30824246 (View on PubMed)

Brown GK, Thase ME, Vittengl JR, Borman PD, Clark LA, Jarrett RB. Assessing cognitive therapy skills comprehension, acquisition, and use by means of an independent observer version of the Skills of Cognitive Therapy (SoCT-IO). Psychol Assess. 2016 Feb;28(2):205-13. doi: 10.1037/pas0000080. Epub 2015 Sep 7.

Reference Type DERIVED
PMID: 26348032 (View on PubMed)

Horner MS, Siegle GJ, Schwartz RM, Price RB, Haggerty AE, Collier A, Friedman ES. C'mon get happy: reduced magnitude and duration of response during a positive-affect induction in depression. Depress Anxiety. 2014 Nov;31(11):952-60. doi: 10.1002/da.22244. Epub 2014 Mar 18.

Reference Type DERIVED
PMID: 24643964 (View on PubMed)

Related Links

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http://www.utsouthwestern.edu/utsw/home/research/prdc/indec.html

Psychosocial Research and Depression Clinic

Other Identifiers

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R01MH058397

Identifier Type: NIH

Identifier Source: secondary_id

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R01MH069619

Identifier Type: NIH

Identifier Source: secondary_id

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R01MH058356

Identifier Type: NIH

Identifier Source: secondary_id

View Link

R01MH069618

Identifier Type: NIH

Identifier Source: secondary_id

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R01MH058397

Identifier Type: NIH

Identifier Source: org_study_id

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NCT00183664

Identifier Type: -

Identifier Source: nct_alias

NCT00218764

Identifier Type: -

Identifier Source: nct_alias

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