Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

BMC Psychiatry

Study Protocol

Marcus JH Huibers¹  Arnoud Arntz¹  Peter J de Jong²  Gerard D van Rijsbergen²  Claudi LH Bockting²  Hermien J Elgersma³  Peter Muris⁴  Frenk PML Peeters⁵  Aart H Schene⁶  Peter de Jonge⁷  Willem A Nolen⁷  Johan Ormel⁷  Steven D Hollon⁸  Erik Buskens⁹  A Dennis Stant⁹ 

[1] Department of Clinical Psychological Science, University of Maastricht, The Netherlands;Department of Clinical Psychology, Groningen University, The Netherlands;Department of Clinical Psychology, Groningen University, The Netherlands;Mental health care center Accare, The Netherlands;Department of Clinical and Health Psychology, Erasmus University, Rotterdam, The Netherlands;Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, The Netherlands;Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;Department of Psychiatry, University Medical Center Groningen, Groningen University, The Netherlands;Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA;Medical Technology Assessment, Department of Epidemiology, University Medical Center Groningen, Groningen University, The Netherlands;

关键词: Major Depressive Disorder;    Major Depressive Disorder;    Attentional Blink;    Cognitive Therapy;    Rapid Serial Visual Presentation;   

DOI  :  10.1186/1471-244X-11-8

 received in 2010-12-10, accepted in 2011-01-12,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMaintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial.Methods/designTherefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences.DiscussionThis will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT.Trial registrationNetherlands Trial Register (NTR): NTR1907

【 授权许可】

CC BY   
© Bockting et al; licensee BioMed Central Ltd. 2011