Trial Outcomes & Findings for Using D-cycloserine to Enhance the Benefits of Cognitive Behavioral Therapy for Schizophrenia (NCT NCT00742079)

NCT ID: NCT00742079

Last Updated: 2017-12-19

Results Overview

Number of alternative beliefs generated on the Alternative Beliefs Assessment. This assessment used nine vignettes describing social interactions: three of neutral content, three negatively-valanced, and three tailored to the patient's specific delusions. Participants were asked to generate as many explanations (alternative beliefs) as they could for each scenario, and the number of explanations produced in response to each item was recorded. Scores could range from 0 to as many explanations a person could produce (no maximum value). The total score was calculated by adding all alternative beliefs generated from each vignette. A higher number of alternative beliefs generated reflects a greater degree of cognitive flexibility.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

21 participants

Primary outcome timeframe

Baseline to Week 2

Results posted on

2017-12-19

Participant Flow

Participants were recruited from an urban community mental health center in Boston, MA from September 2006 to May 2010.

31 participants were screened, 10 were excluded (7 did not meet inclusion criteria and 2 refused to participate, 1 excluded for reasons not listed in study publication)

Participant milestones

Participant milestones
Measure
1 D-cycloserine First, Then Placebo
Participants received 50 mg D-cycloserine 1 hour before a cognitive behavioral therapy (CBT) session on Week 1, and then received placebo 1 hour before a CBT session on Week 2.
2 Placebo First, Then D-cycloserine
Participants received placebo 1 hour before a CBT session on Week 1, and then received 50 mg D-cycloserine 1 hour before a CBT session on Week 2.
Overall Study
STARTED
11
10
Overall Study
Baseline/Week 1 (Received Dose 1)
11
9
Overall Study
Week 2 (Received Dose 2)
11
9
Overall Study
COMPLETED
11
9
Overall Study
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
1 D-cycloserine First, Then Placebo
Participants received 50 mg D-cycloserine 1 hour before a cognitive behavioral therapy (CBT) session on Week 1, and then received placebo 1 hour before a CBT session on Week 2.
2 Placebo First, Then D-cycloserine
Participants received placebo 1 hour before a CBT session on Week 1, and then received 50 mg D-cycloserine 1 hour before a CBT session on Week 2.
Overall Study
Lost to Follow-up
0
1

Baseline Characteristics

Using D-cycloserine to Enhance the Benefits of Cognitive Behavioral Therapy for Schizophrenia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
1 D-cycloserine, Then Placebo
n=11 Participants
Participants received 50 mg D-cycloserine 1 hour before a cognitive behavioral therapy (CBT) session on Week 1, and then received placebo 1 hour before a CBT session on Week 2.
2 Placebo, Then D-cycloserine
n=9 Participants
Participants received placebo 1 hour before a CBT session on Week 1, and then received 50 mg D-cycloserine 1 hour before a CBT session on Week 2.
Total
n=20 Participants
Total of all reporting groups
Age, Continuous
49.2 years
STANDARD_DEVIATION 9.0 • n=5 Participants
51.4 years
STANDARD_DEVIATION 13.0 • n=7 Participants
50.2 years
STANDARD_DEVIATION 10.7 • n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants
Sex: Female, Male
Male
6 Participants
n=5 Participants
7 Participants
n=7 Participants
13 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race (NIH/OMB)
White
7 Participants
n=5 Participants
6 Participants
n=7 Participants
13 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
11 participants
n=5 Participants
9 participants
n=7 Participants
20 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline to Week 2

Number of alternative beliefs generated on the Alternative Beliefs Assessment. This assessment used nine vignettes describing social interactions: three of neutral content, three negatively-valanced, and three tailored to the patient's specific delusions. Participants were asked to generate as many explanations (alternative beliefs) as they could for each scenario, and the number of explanations produced in response to each item was recorded. Scores could range from 0 to as many explanations a person could produce (no maximum value). The total score was calculated by adding all alternative beliefs generated from each vignette. A higher number of alternative beliefs generated reflects a greater degree of cognitive flexibility.

Outcome measures

Outcome measures
Measure
D-cycloserine
n=20 Participants
Participants receive 50 mg of D-cycloserine
Placebo
n=20 Participants
Participants receive 50 mg of placebo
Change in Alternative Beliefs Assessment
14.05 units on a scale
Standard Deviation 12.71
10.70 units on a scale
Standard Deviation 16.08

SECONDARY outcome

Timeframe: Baseline to Week 2

The Delusions subscale is a 6 item clinician administered scale, with Likert items 0-4 and range is 0-24. Higher scores represent worse outcomes

Outcome measures

Outcome measures
Measure
D-cycloserine
n=19 Participants
Participants receive 50 mg of D-cycloserine
Placebo
n=19 Participants
Participants receive 50 mg of placebo
Change in Psychotic Rating Scales (PSYRATS) Delusion Score
-0.89 units on a scale
Standard Deviation 2.49
-0.47 units on a scale
Standard Deviation 3.08

SECONDARY outcome

Timeframe: Baseline to Week 2

The BCIS is a 15-item self-report scale with Likert items 0-3. It consists of a composite score, where higher scores represent better outcomes, and there are 2 subscales: 1) Self-Reflectiveness (higher scores represent better outcomes) and 2) Self-Certainty (higher scores represent worse outcomes). The total score for each scale is the sum of the item scores that comprise it (see below). The BCIS composite index is calculated as self-reflectiveness minus self-certainty. Step 1. Score every item on the BCIS from "0" to "3" according to the following rule: "Do Not Agree at All" = 0, "Agree Slightly" = 1, "Agree a Lot" = 2, "Agree Completely" = 3 Step 2. Calculate self-reflectiveness subscale: sum items 1, 3, 4, 5, 6, 8, 12, 14, and 15. Step 3. Calculate self-certainty subscale: sum items 2, 7, 9, 10, 11, and 13. Step 4. Calculate BCIS composite index: self-reflectiveness minus self-certainty.

Outcome measures

Outcome measures
Measure
D-cycloserine
n=19 Participants
Participants receive 50 mg of D-cycloserine
Placebo
n=18 Participants
Participants receive 50 mg of placebo
Change in Beck Cognitive Insight Scale (BCIS)
Composite Score
-0.26 units on a scale
Standard Deviation 3.46
0.44 units on a scale
Standard Deviation 4.16
Change in Beck Cognitive Insight Scale (BCIS)
Self-Certainty Score
0.11 units on a scale
Standard Deviation 3.68
-0.56 units on a scale
Standard Deviation 2.64
Change in Beck Cognitive Insight Scale (BCIS)
Self-Reflectiveness Score
-0.16 units on a scale
Standard Deviation 2.81
-0.11 units on a scale
Standard Deviation 3.23

SECONDARY outcome

Timeframe: Baseline to Week 2

The Bead task is a reasoning task, where the number of beads guessed is the numeric value represented in the data. The lower end range is 1, and there is no upper range limit. Higher scores represent better outcomes.

Outcome measures

Outcome measures
Measure
D-cycloserine
n=20 Participants
Participants receive 50 mg of D-cycloserine
Placebo
n=20 Participants
Participants receive 50 mg of placebo
Change in Bead Task Score Measuring Probabilistic Reasoning
0.45 units on a scale
Standard Deviation 4.47
0.10 units on a scale
Standard Deviation 5.16

SECONDARY outcome

Timeframe: Baseline to Week 2

This scale is a one-question item added on to the Bead Task. The one item asks for a certainty rating, from 1-3. Higher scores represent better outcomes.

Outcome measures

Outcome measures
Measure
D-cycloserine
n=19 Participants
Participants receive 50 mg of D-cycloserine
Placebo
n=19 Participants
Participants receive 50 mg of placebo
Change in the Maudsley Assessment of Delusions Scale
0.05 units on a scale
Standard Deviation 0.40
-0.16 units on a scale
Standard Deviation 0.37

Adverse Events

1 D-cycloserine, Then Placebo

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

2 Placebo, Then D-cycloserine

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Jennifer Gottlieb, PhD

Massachusetts General Hospital

Phone: 617-912-7800

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place