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      Effectiveness, relapse prevention and mechanisms of change of cognitive therapy vs. interpersonal therapy for depression: Study protocol for a randomised controlled trial

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          Abstract

          Background

          Major depression is a common mental disorder that substantially impairs quality of life and has high societal costs. Although psychotherapies have proven to be effective antidepressant treatments, initial response rates are insufficient and the risk of relapse and recurrence is high. Improvement of treatments is badly needed. Studying the mechanisms of change in treatment might be a good investment for improving everyday mental health care. However, the mechanisms underlying therapeutic change remain largely unknown. The objective of the current study is to assess both the effectiveness of two commonly used psychotherapies for depression in terms of reduction of symptoms and prevention of relapse on short and long term, as well as identifying underlying mechanisms of change.

          Methods

          In a randomised trial we will compare (a) Cognitive Therapy (CT) with (b) Interpersonal therapy (IPT), and (c) an 8-week waiting list condition followed by treatment of choice. One hundred eighty depressed patients (aged 18-65) will be recruited in a mental health care centre in Maastricht (the Netherlands). Eligible patients will be randomly allocated to one of the three intervention groups. The primary outcome measure of the clinical evaluation is depression severity measured by the Beck Depression Intenvory-II (BDI-II). Other outcomes include process variables such as dysfunctional beliefs, negative attributions, and interpersonal problems. All self-report outcome assessments will take place on the internet at baseline, three, seven, eight, nine, ten, eleven, twelve and twenty-four months. At 24 months a retrospective telephone interview will be administered. Furthermore, a rudimentary analysis of the cost-effectiveness will be embedded. The study has been ethically approved and registered.

          Discussion

          By comparing CT and IPT head-to-head and by investigating multiple potential mediators and outcomes at multiple time points during and after therapy, we hope to provide new insights in the effectiveness and mechanisms of change of CT and IPT for depression, and contribute to the improvement of mental health care for adults suffering from depression.

          Trial registration

          The study has been registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre ( ISRCTN67561918)

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          Most cited references74

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          The measurement of pessimism: the hopelessness scale.

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            Inventory of interpersonal problems: psychometric properties and clinical applications.

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              Understanding and using the Implicit Association Test: II. Method variables and construct validity.

              The Implicit Association Test (IAT) assesses relative strengths of four associations involving two pairs of contrasted concepts (e.g., male-female and family-career). In four studies, analyses of data from 11 Web IATs, averaging 12,000 respondents per data set, supported the following conclusions: (a) sorting IAT trials into subsets does not yield conceptually distinct measures; (b) valid IAT measures can be produced using as few as two items to represent each concept; (c) there are conditions for which the administration order of IAT and self-report measures does not alter psychometric properties of either measure; and (d) a known extraneous effect of IAT task block order was sharply reduced by using extra practice trials. Together, these analyses provide additional construct validation for the IAT and suggest practical guidelines to users of the IAT.
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                Author and article information

                Journal
                Trials
                Trials
                BioMed Central
                1745-6215
                2011
                14 June 2011
                : 12
                : 150
                Affiliations
                [1 ]Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, the Netherlands
                [2 ]Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, Maastricht, the Netherlands
                [3 ]Vanderbilt University, Department of Psychology, Nashville, Tennessee, USA
                Article
                1745-6215-12-150
                10.1186/1745-6215-12-150
                3136406
                21672217
                fdfaf0a4-1fc7-4574-8885-59434a12596e
                Copyright ©2011 Lemmens et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 April 2011
                : 14 June 2011
                Categories
                Study Protocol

                Medicine
                Medicine

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