Major Depression Clinical Trial
Official title:
Depression Agency-Based Collaborative (Depression ABC)
Seniors who receive supportive services face a variety of psychosocial vulnerabilities that put them at risk for depression. One group with very high risk is older adults receiving aging services through Medicaid waiver programs. This 3-year research uses a randomized controlled clinical trial to assess the effectiveness of brief behavioral therapies (problem solving therapy [PST] and Brief Behavioral Therapy for Insomnia [BBTI]) to prevent depression in seniors receiving aging services.
The research will determine (i) if a course of problem solving therapy (PST) and Brief
Behavioral Therapy for Insomnia (BBTI), with boosters, reduces incidence of major depressive
episodes over 12 months relative to usual care, and (ii) the extent to which behavioral
therapies achieve these effects through enhancement of protective factors, such as greater
self-efficacy, better targeting of services to address needs, and greater control over home
environments.
Periodic blood draws will be used to assess biosignatures of depression. Guiding our
investigations of pharmacogenetics, inflammation, and proteomics are synergistic
interactions among the serotonergic system, the HPA axis, systemic inflammation, growth
factors such as brain derived neuro-trophic factor (BDNF), psychosocial stressors, and
vascular co-morbidity. Genetic variation in vasopressin receptors, potentially involved in
both cardiovascular risk and social attachment, is also associated with recurrence of
depression. Similarly, genetic variation in inflammation may influence antidepressant
response and medical co-morbidity.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Prevention
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