Major Depressive Disorder Clinical Trial
Official title:
A 12-week Multidomain Intervention With Contingency Management for Older Adults With Major Depressive Disorder: A Community-based Randomized Clinical Trial
To assess the effectiveness of a 12-week multidomain intervention with contingency management for reducing depressive symptoms in older adults with major depressive disorder.
Awareness of the necessity and importance of community-based multidomain psychosocial
intervention for late-life depression has increased. However, few studies have attempted to
integrate several therapeutic approaches in one intervention program.
Main objective of this study is to assess the effectiveness of a 12-week multidomain
intervention with contingency management for reducing depressive symptoms in older adults
with major depressive disorder.
We plan to conduct a randomized controlled parallel-design study. We plan to allocate study
participants to multidomain intervention or supportive therapy group, in a 1:1 ratio. Block
randomization using SAS (PLAN procedure) and sample size estimation were performed. We
estimated that, with at least 40 participants per group and an attrition rate of 10%, we
could achieve a power of at least 0.80 (beta = 0.2, two-tailed alpha = 0.05).
Intervention was based on the financial and human resources of a community mental health
service, and involved four home visits and 12 telephone calls over 12 weeks. Four
evidence-based therapeutic approaches (physical activity, healthy diet, social activity, and
emotional regulation) were incorporated into the multidomain intervention program. To
maintain participant motivation, we plan to apply contingency management based on operant
conditioning theory.
The primary outcome is the change in depressive symptoms, as measured by the
Montgomery-Asberg Depression Rating Scale (MADRS). Secondarily, we plan to investigate
changes in resting-state functional connectivity in the default mode, salience, and central
executive networks.
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