Depression Clinical Trial
Official title:
Personalizing Treatment of Depression Complicated by Panic Features-Pilot Study
This study will examine the feasibility and efficacy of a personalized psychotherapy treatment for people with depression and co-occurring anxiety.
Approximately one half of all depressed psychiatric patients also meet the criteria for an
anxiety disorder. Compared to people with only depression, people with both depression and
panic features experience poorer psychological and social functioning, a greater risk of
suicide, less response to medication and therapy treatment, and a greater risk of recurring
symptoms. Because people with depression and co-occurring anxiety features do not achieve
full symptom remission with either medication or therapy alone, this study will use a
treatment that combines the two. A commonly used type of depression medication called a
selective serotonin reuptake inhibitor (SSRI) will be combined with a specialized therapy
developed to address depression with co-occurring symptoms of panic, anxiety, and avoidance.
This study will also test a computer-based method of assessing mood and anxiety symptom
profiles and outcomes to determine whether participants find this method acceptable and
clinicians find it useful.
Participation in this study will last 20 weeks, with follow-up visits occurring 4 and 8
months after starting. Participants will be randomly assigned to receive either an
individualized therapy for depression and anxiety, called interpersonal psychotherapy for
depression with panic and anxiety symptoms (IPT-PS), or a standard therapy for depression,
called brief supportive psychotherapy (BSP). All participants will complete up to 16 therapy
sessions and receive a standard SSRI treatment with the medication citalopram hydrobromide.
During the IPT-PS treatment, a study therapist will examine regular computer updates of
depression and anxiety scores for participants and talk to them about identifying and
addressing life stressors that trigger symptoms. During the BSP treatment, a study therapist
will encourage participants to arrive at their own solutions by emphasizing the
participants' strengths and examining what has worked in the past.
Participants will complete assessments weekly during the 20 weeks of the study intervention
and at 4- and 8-month follow-up visits. These assessments will include self-report
questionnaires about symptoms, medication side effects, and treatment adherence; vital sign
and weight measurements; and a clinical interview. Regular assessments of medication
effectiveness and side effects will occur every 1 to 4 weeks. Starting at the second study
visit, participants will also complete monthly computer-based questionnaires about
depression and anxiety symptoms.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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