Depression Clinical Trial
Official title:
Improving Access to Evidence-based Treatment for Depression: Effectiveness and Cost-effectiveness of Telephone-delivered Cognitive Behavioral Therapy (CBT) in Primary Care
The aim of the study is the examination of effectiveness and cost-effectiveness of a telephone-based psychotherapy (Tel-PT) for depression compared to treatment as usual in primary care.
The overall purpose of the study is to examine the effectiveness of telephone psychotherapy
(Tel-PT) for the treatment of mild to moderate depression on different outcome-levels and
under clinically representative conditions in Swiss primary health care. The
randomized-controlled trial (RCT) will evaluate the primary hypothesis that Tel-PT is more
effective than routine primary care (i.e. treatment as usual, TAU), more specifically, that
it leads to significant higher reduction in depression severity than TAU at follow-up.
The intervention group (IG) receives a manualized short-term cognitive behavioral treatment,
which is the adapted German version of the program "Creating a balance" developed in the USA.
The therapy consists of one face-to-face and 8-12 telephone contacts and is carried out by a
licensed psychotherapist.
More concrete, recruitment and inclusion of the patients will be carried out by the
participating general practitioners (GPs). GPs will be instructed to screen patients at risk
for depression, especially those revealing diffuse somatic symptoms and suffering from
chronic diseases. If positively screened, patient`s depressive symptoms are assessed with
Patient Health Questionnaire (PHQ-9) and diagnosed according to ICD-10.
All GPs will receive an initial training prior to their participation, providing them with
study information and procedures as well as training in screening procedure,
psychodiagnostics and study enrolment.
Eligible patients are provided with detailed study information and asked to participate.
Subsequently, patients will give informed consent. Patients will then be included into the
study and fill out the baseline questionnaires (t0). After that, randomization will be
carried out at the University of Zurich, based on an appropriately created computer
algorithm. Both GPs and patients are informed about the results by the study team within two
days. Subsequently, patients in control group (CG) will receive regular text messages and
patients in the intervention group (IG) will be called by the study therapist to schedule an
initial appointment.
In case of positive results, the overarching objective is the optimization of mental health
services for depressed patients by implementing an evidence-based, accessible and
cost-effective treatment option into primary care.
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