Cognitive therapy for unipolar depression: effect of a dilemma-focused intervention

ISRCTN ISRCTN92443999
DOI https://doi.org/10.1186/ISRCTN92443999
ClinicalTrials.gov number NCT01542957
Secondary identifying numbers PSI2011-23246
Submission date
04/08/2012
Registration date
23/08/2012
Last edited
16/04/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Depression is one of the most common mental disorders worldwide. The symptoms of depression can vary greatly from person to person, but generally include low mood, problems with sleeping and/or eating, and loss of interest in life. Depression comes in many forms, and two of the most recognised are major depressive disorder (MDD), and dysthymic disorder (DD). MMD is diagnosed when symptoms begin suddenly, last for at least two weeks and are serious enough to affect day to day life. The symptoms of DD are not quite as severe as in MDD, but last for at least two years. Although a good deal of progress has been made, the success in the treatment of these disorders is limited, as patients have a tendency to relapse. One of the reasons for this is thought to be that people suffering from these disorders have an internal struggle going on, which creates suffering and blocks their personal development (cognitive conflict). The aim of this study is to find out whether having individual dilemma-focused therapy (DFT) in combination with cognitive behavioural therapy (CBT) will be more effective than CBT alone in treating patients suffering from MDD and DD.

Who can participate?
Adults suffering from moderate to severe MDD or DD who have at least one cognitive conflict.

What does the study involve?
At the start of the study, the participants undergo a psychological assessment, in order to establish a definitive diagnosis. All participants are then given eight weekly 2 hour sessions of group CBT. They are randomly allocated into two groups. One group are given 8 individual CBT weekly sessions. The second group are given 8 individual DFT weekly sessions. After the participants have finished the course of individual therapy, they are assessed again in order to see if there is any change to their condition. This assessment is repeated twice more after three months and then after one year.

What are the possible benefits and risks of participating?
A potential benefit of participating is that participants will have access to therapies which are not usually offered, which may help their conditions. There are no notable risks of taking part in the trial.

Where is the study run from?
Universitat de Barcelona (Spain)

When is study starting and how long is it expected to run for?
November 2011 to June 2014

Who is funding the study?
Ministry of Economy, Secretary of Research, Development and Innovation (Spain)

Who is the main contact?
Dr Guillem Feixas
gfeixas@ub.edu

Study website

Contact information

Prof Guillem Feixas
Scientific

Universitat de Barcelona
Campus Mundet - Psicologia
Edifici Ponent, despatx 3601
Passeig Vall d'Hebron, 171
Barcelona
08035
Spain

Phone +34933125100
Email gfeixas@ub.edu

Study information

Study designRandomised single-blind treatment efficacy study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet http://www.ub.edu/terdep
Scientific titleCognitive therapy for unipolar Depression: efficacy of a dilemma-focused intervention, a randomised controlled trial
Study acronymCTFORDEP
Study objectivesA new brief intervention focused on the dilemma(s) specifically detected for each patient in addition to CBT will be more efficacious than CBT alone. Patients diagnosed with Major Depressive Disorder and those with Dysthymic Disorcer allocated in the combined dilemma-focused and CBT will show higher reductions in depressive symptoms and more general improvement in functioning and wellbeing.
Ethics approval(s)University of Barcelona Ethics Committee, 04 July 2011, ref: IRB00003099
Hospital of Mataró Ethics Committee 21 December 2011
Health condition(s) or problem(s) studiedMajor Depressive Disorder, dysthymic disorder.
InterventionCombined Group Cognitive Behavioral (8, 2-hour weekly sessions) and Individual Dilemma-Focused Therapy (8, 1-hour weekly sessions)
Cognitive Behavioral Therapy (8, 2-hour group weekly sessions and 8, 1-hour individual weekly sessions)
Intervention typeOther
Primary outcome measureChange from baseline in Beck Depression Inventory-Second Edition (BDI-II) at the end of therapy.
Secondary outcome measures1. Change from baseline in Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) at the end of therapy
2. Change from baseline in Hamilton Anxiety Rating Scale (HARS) at the end of therapy
3. Change from baseline in measures of the Repertory Grid Technique
Overall study start date20/11/2011
Completion date30/06/2014

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants112 patients. To achieve minimal requirements of statistical analysis, some additional recruiting will be needed if too few men or dysthymic patients are included for the study.
Total final enrolment128
Key inclusion criteria1. Aged 18 to 70 years old
2. Both genders
3. Meeting diagnostic criteria for Major Depressive Disorder (MDD) or Dysthymic Disorder (DD) according to the DSM-IV-TR (APA, 2002) criteria assessed using SCID-I
4. A score above 19 on the BDI-II Questionnaire
5. Presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct) as assessed using the Repertory Grid Technique
6. Enough level of competence to communicate in Spanish or Catalan
Key exclusion criteria1. Bipolar disorders
2. Psychotic symptoms
3. Substance abuse
4. Organic brain dysfunction
5. Mental retardation
6. Serious suicidal ideation
7. Receiving psychological treatment (unless it is suspended at the time of inclusion in the study itself, in agreement with the patient and the practitioner applying it)
8. Substantial visual, hearing or cognitive deficits
Date of first enrolment20/11/2011
Date of final enrolment30/06/2014

Locations

Countries of recruitment

  • Spain

Study participating centre

Universitat de Barcelona
Barcelona
08035
Spain

Sponsor information

University of Barcelona (Spain)
University/education

Department of Personality
Assessment and Psychological Treatment
Faculty of Psychology
Campus Mundet (UB)
Passeig Vall d'Hebron, 171
Facultat de Psicologia
Barcelona
08035
Spain

Phone +34933125100
Email gfeixas@ub.edu
Website http://www.ub.edu/terdep
ROR logo "ROR" https://ror.org/021018s57

Funders

Funder type

Government

Ministry of Economy, Secretary of Research, Development and Innovation (Spain) ref: PSI2011-23246

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 17/05/2013 25/10/2013 Yes No
Results article results 01/09/2016 16/04/2019 Yes No
Results article results 01/01/2017 16/04/2019 Yes No
Results article results 13/12/2018 16/04/2019 Yes No

Editorial Notes

16/04/2019: Publication reference and total final enrolment added.