Combined Interventions for Treating Depression and Chronic Back Pain

NCT ID: NCT00158275

Last Updated: 2017-10-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

71 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-10-31

Study Completion Date

2006-08-31

Brief Summary

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This study will determine the effectiveness of an intervention consisting of combined strategies in reducing the symptoms of both depression and chronic back pain.

Detailed Description

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The relationship between depression and back pain is complex. Depression is the most common mental condition associated with chronic back pain. Despite this relationship, many patients with depression and back pain seek treatment only for one of the two conditions, which can worsen the untreated condition. An intervention that reduces the symptoms of both depression and back pain is needed. This study will determine the effectiveness of an integrated intervention in reducing both back pain and depression symptoms.

Participants will be randomly assigned to receive either an integrated intervention or standard of care for 6 months. Participants in the integrated intervention group will receive cognitive behavioral therapy for back pain and antidepressants and/or problem solving therapy for depression. Study visits will initially occur once a week and then taper to once every 2 weeks for the 6-month duration; the time of tapering will depend on participant response to treatment and will be at the investigator's discretion. Depression and back pain symptoms will be assessed in all participants at study entry, at the end of treatment, and 6 months after the end of treatment. The study entry and study completion assessments will occur during study visits. The last assessment will be a telephone interview.

Conditions

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Back Pain Depression

Keywords

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Cognitive behavioral therapy Problem solving therapy CBT

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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Integrated Intervention

Participants will receive cognitive behavioral therapy for back pain and antidepressants and/or problem solving therapy for depression. Study visits will initially occur once a week and then taper to once every 2 weeks for the 6-month duration.

Group Type EXPERIMENTAL

Cognitive behavioral therapy

Intervention Type BEHAVIORAL

Cognitive behavioral therapy focuses on identifying and eliminating maladaptive beliefs and thoughts.

Antidepressants

Intervention Type DRUG

Antidepressant drugs try to eliminate symptoms of depression such as persistent sadness and disinterest in normal or pleasurable activities.

Problem solving therapy

Intervention Type BEHAVIORAL

Problem solving therapy identifies problems that interfere with everyday functions and that contribute to depression and disability. The treatment then provides compensatory strategies that are designed to bypass the person's cognitive limitations and to improve adaptive functioning in the home environment.

Standard of Care

Participants will receive care as usual from their health care provider.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Cognitive behavioral therapy

Cognitive behavioral therapy focuses on identifying and eliminating maladaptive beliefs and thoughts.

Intervention Type BEHAVIORAL

Antidepressants

Antidepressant drugs try to eliminate symptoms of depression such as persistent sadness and disinterest in normal or pleasurable activities.

Intervention Type DRUG

Problem solving therapy

Problem solving therapy identifies problems that interfere with everyday functions and that contribute to depression and disability. The treatment then provides compensatory strategies that are designed to bypass the person's cognitive limitations and to improve adaptive functioning in the home environment.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Roland back pain score of 7 or greater
* Diagnosis of major depression
* Plan to stay enrolled in Group Health Cooperative for the duration of the study and 1 year after the study

Exclusion Criteria

* Prior surgery
* Cauda equina syndrome (compression and paralysis of nerve roots)
* Schizophrenia or bipolar disorder treatment within 2 years prior to study entry
* Current or prior psychiatric or psychological care for back pain or depression
* At high risk for suicide
Minimum Eligible Age

25 Years

Maximum Eligible Age

74 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Kaiser Permanente

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michael R. VonKorff, ScD

Role: PRINCIPAL_INVESTIGATOR

Kaiser Permanente

Locations

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Group Health Cooperative

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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R34MH070642

Identifier Type: NIH

Identifier Source: secondary_id

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DSIR 83-ATAS

Identifier Type: -

Identifier Source: secondary_id

R34MH070642

Identifier Type: NIH

Identifier Source: org_study_id

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