Depression Clinical Trial
Official title:
Phase 1 Study: Evaluation of Three Continuation Therapies After Acute Electroconvusive Therapy (ECT) Concerning Efficacy and Cognition in Severly Depressed Patients
The purpose of this study is to evaluate three different continuation treatments after acute ECT concerning efficacy and impact on cognition in severly depressed patients.
BACKGROUND While electroconvulsive therapy (ECT) in major depression is effective, high
relapse rates and cognitive effects limit its long-term use. Continuation treatment after
ECT with combinations of C-ECT or psychotherapy and medication may decrease relapse rates
and cognitive side effects while changing cognitive psychological variables like
dysfunctional attitudes in the long-term.
CENTRAL RESEARCH QUESTIONS
- Evaluation of the efficacy of three continuation treatments aimed at preventing
relapses after acute ECT
- Examination of the cognitive side effects and the changes of cognitive psychological
variables during acute and continuation treatment
METHODS In a prospective, randomized, controlled, long-term study we assign 60 depressed ECT
responder either to antidepressant treatment alone, or C-ECT plus medication, or cognitive
behavioral group therapy plus medication. Depressive symptoms and cognition were assessed
before, during, immediately after acute ECT and two, four, six, and 12 months during
continuation therapy.
HYPOTHESES It is hypothesized that the use of combination continuation therapies after
effective ECT leads to lower HAMD scores and lower relapse rates than the standard treatment
with antidepressants alone after 6 months. In addition, we assume that the CBT group will
establish more functional macro-patterns than the somatic treatments in the long term and
will have the lowest HAMD scores and relapse rates after 1 year. With regard to the
cognitive side effects, the autobiographical memory is expected to be the only specific part
of memory being affected negatively by ECT in the short and long term.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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