Acceptance and Commitment Therapy Versus Cognitive Therapy for the Treatment of Major Depressive Disorder

Overview

The study will investigate the effectiveness of Cognitive Therapy and Acceptance and Commitment Therapy in a randomized controlled trial among patients with Major Depressive Disorder in routine clinical practice. Furthermore, the study will investigate whether each specific treatment approach is mediated by its proposed theoretical mechanism.

Full Title of Study: “Acceptance and Commitment Therapy vs. Cognitive Therapy for the Treatment of Major Depressive Disorder”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: August 2015

Detailed Description

The current study aims at investigating the effectiveness of Cognitive Therapy and Acceptance and Commitment Therapy in a randomized controlled trial among patients with MDD in routine clinical practice. Further, the study will investigate whether each specific treatment approach is mediated by its proposed theoretical mechanism. Patients have to meet diagnostic criteria for nonpsychotic MDD as determined by the Structured Interview for DSM-IV. Each client will receive either Cognitive Therapy or Acceptance and Commitment Therapy that will last between 16 to 20 sessions. Based on previous results, it is expected that both treatment forms will prove beneficial for the patients.

Interventions

  • Behavioral: Cognitive Therapy
    • This interventions will target: (a) behavioral dysfunction, (b) situation-specific negative thinking and cognitive distortions, and (c) underlying dysfunctional beliefs or cognitions assumed to be related to the patient’s current depression and risk of future depression. A maximum of 20 45-55 minute sessions will be provided, with sessions generally held weekly for the first 8 sessions and once every two weeks for the next 8 sessions.
  • Behavioral: Acceptance and Commitment Therapy
    • This interventions will use (a) acceptance, (b) commitment, (c) mindfulness, and (d) behavior change processes to produce reduction of depressive symptoms. A maximum of 20 45-55 minute sessions will be provided, with sessions generally held weekly for the first 8 sessions and once every two weeks for the next 8 sessions.

Arms, Groups and Cohorts

  • Experimental: Cognitive Therapy (CT)
    • Cognitive Therapy (CT)
  • Experimental: Acceptance and Commitment Therapy (ACT)
    • Acceptance and Commitment Therapy (ACT)

Clinical Trial Outcome Measures

Primary Measures

  • QUICK INVENTORY OF DEPRESSIVE SYMPTOMATOLOGY (QIDS-SR)
    • Time Frame: pre-treatment, post-treatment, 6 and 12 months follow-up
    • Change from pre-treatment to post-treatment, 6 months follow-up and 12 months follow-up
  • Hamilton Rating Scale for Depression
    • Time Frame: pre-treatment, post-treatment
    • Change from pre-treatment to post-treatment.

Secondary Measures

  • Decentering subscale of the Experiences Questionnaire
    • Time Frame: Pre-treatment, in-treatment, and 6 and 12 months follow-up.
    • Change between sessions and to follow-up.
  • Acceptance and Action Questionnaire
    • Time Frame: Pre-treatment, in-treatment, and 6 and 12 months follow-up.
    • Change between sessions and to follow-up.
  • Dysfunctional Attitude Scale-revised
    • Time Frame: Pre-treatment, in-treatment, and 6 and 12 months follow-up
    • Change between sessions to follow-up.
  • Working Alliance Inventory
    • Time Frame: 3. session
  • Eurohis Quality of Life Scale
    • Time Frame: Pre-, post-treatment, 6 and 12 months follow-up
    • Change pre-treatment to post-treatment and to follow-up.
  • Relationship Scales
    • Time Frame: Pre-, post-treatment, 12 months follow-up
    • Change pre-treatment to post-treatment and to follow-up.
  • Implicit Attitude Test
    • Time Frame: Pre- and posttreatment
    • Change pre-treatment to post-treatment
  • Structured Clinical Interview for DSM-IV (Major Depression Module)
    • Time Frame: Pre-treatment and post-treatment.
    • Change in diagnosis of Major Depression Disorder from pre-treatment to post-treatment.

Participating in This Clinical Trial

Inclusion Criteria

1. Meeting DSM-IV criteria for MDD 2. Between the ages of 18 and 65-years-old 3. Having sufficient fluency in Dutch to complete treatment and research protocol Exclusion Criteria:

1. DSM-IV criteria for bipolar disorder (past or present) 2. Psychotic disorders 3. Substance dependence disorders (current or within the past 6 months), or 4. Organic brain syndrome. 5. Borderline or antisocial personality disorder

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • VU University of Amsterdam
  • Provider of Information About this Clinical Study
    • Principal Investigator: Paul M.G.Emmelkamp, Professor – VU University of Amsterdam
  • Overall Official(s)
    • Paul MG Emmelkamp, PhD, Principal Investigator, University of Amsterdam
    • Nexhmedin Morina, PhD, Study Director, University of Amsterdam

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