Major Depression Clinical Trial
Official title:
Clinical Characteristics and Structural Changes in Magnetic Resonance Imaging: Importance for the Outcome of Late Life Depression
Predictors of response to pharmacological treatment of major depressive disorder will be investigated. One hundred and twenty patients will be included in a naturalistic clinical trial. Psychopathology, personality traits, cognitive performance, brain structural changes and genetic polymorphisms will be evaluated. Patients will be followed for 18 months with a pharmacological treatment algorithm and will be evaluated monthly until 6th month and every 3 months, up to 18 months. Psychoeducation will be offered to patients who did not remit until 3 months of pharmacological tretment.
The relevance of depression prevention and treatment in older people tend to raise in future
years, considering the rapid increase of the elderly population in Brazil and the growing
impact of depression (the third cause of global burden of diseases in the world according to
the World Health Association 2004 report). The association between structural brain changes
and treatment response in patients with late-life depression (LLD) remains an intriguing area
of research. Predictors of response to pharmacological treatment of major depressive disorder
will be investigated in 120 elderly patients, who will be included in a naturalistic clinical
trial, that will evaluate psychopathology, personality traits, cognitive performance, brain
structural changes and genetic polymorphisms. Patients will be followed for 18 months with a
treatment algorithm for depression and will be evaluated monthly until 6th month and every 3
months, up to 18 months, to assess factors associated to response to treatment.
Patients who are in the antidepressant treatment group and does not reach remission (MADRS
score <or =8) until 3 months of pharmacological treatment will be invited to be part of a
psychoeducation program. If the patient accepts the psychoeducation intervention, he will be
randomized to psychoeducation (pharmacological treatment plus psychoeducation) or treatment
as usual (only pharmacological treatment). The psychoeducation program consists of 10
individual weekly sessions, conducted by a trained psychologist who will explain the main
concepts of depression and its symptoms, the importance of adhering to treatment, the main
side effects of pharmacological treatment, and how to cope with daily difficulties.
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