Treatment of chronically depressed patients: a multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) for chronic depressions versus usual secondary care.

Department of Psychiatry and Institute for Research in Extramural Medicine, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, Stichting GGZBuitenamstel-de Geestgronden, The Netherlands.
BMC Psychiatry (Impact Factor: 2.23). 02/2008; 8:18. DOI: 10.1186/1471-244X-8-18
Source: PubMed

ABSTRACT 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) is a form of psychotherapy specifically developed for patients with chronic depression. In a study in the U.S., remarkable favorable effects of CBASP have been demonstrated. However, no other studies have as yet replicated these findings and CBASP has not been tested outside the United States. This protocol describes a randomized controlled trial on the effectiveness of CBASP in the Netherlands.
The purpose of the present paper is to report the study protocol of a multisite randomized controlled trial testing the effectiveness of 'Cognitive Behavioral Analysis System of Psychotherapy' (CBASP) for chronic depression in the Netherlands. In this study, CBASP in combination with medication, will be tested versus usual secondary care in combination with medication. The aim is to recruit 160 patients from three mental health care organizations. Depressive symptoms will be assessed at baseline, after 8 weeks, 16 weeks, 32 weeks and 52 weeks, using the 28-item Inventory for Depressive Symptomatology (IDS). Effect modification by co morbid anxiety, alcohol consumption, general and social functioning and working alliance will be tested. GEE analyses of covariance, controlling for baseline value and center will be used to estimate the overall treatment effectiveness (difference in IDS score) at post-treatment and follow up. The primary analysis will be by 'intention to treat' using double sided tests. An economic analysis will compare the two groups in terms of mean costs and cost-effectiveness from a societal perspective.
The study will provide an answer to the question whether the favorable effects of CBASP can be replicated outside the US.
The Dutch Cochrane Center, NTR1090.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Treatment resistant depressant (TRD) is classified in different staging models, but these are not used routinely. We aimed to identify staging models for TRD and compare them regarding predictive utility and reliability. Systematic review of Pubmed, Embase and PsycINFO (1985-January 2010) without language limits, plus articles identified from reference lists of previous reviews. We excluded articles focusing on TRD treatment. We qualitatively summarized characteristics of the identified staging models, describing strengths and limitations for each model. If available, we reported results of validation studies. From 950 retrieved articles five staging models were found; the Antidepressant Treatment History Form, Thase and Rush Model, European Staging Model, Massachusetts General Hospital Staging model and the Maudsley Staging Model (MSM). Six studies investigated the predictive utility (of four models). We observed an evolution from single antidepressant adequacy ratings, towards a multidimensional and more continuous scored staging model which also introduced TRD characteristics (severity and duration). The operationalization criteria improved; the scoring of different treatment strategies (between/within class switching and augmentation/combination) changed according to the existing evidence. Over time, efforts to validate models improved. The predictive utility was assessed best for the MSM. Few staging models existed; their reliability was hardly assessed. Despite validation of the MSM, further investigation of the reliability and predictive utility of TRD staging models and additional disease characteristics is required. Correct staging of TRD might improve generalizability of results from clinical studies and improve delivery of care to TRD patients. We propose methods to validate staging models in TRD.
    Journal of affective disorders 03/2011; 137(1-3):35-45. · 3.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A simple and effective route for the direct synthesis of Mo2C coatings on graphite matrix is introduced for the joining of copper alloy heat sinks to graphite materials in Tokamak devices. The composition and microstructure of the Mo2C coatings on graphite, and the wetting behaviors of molten copper on coated and uncoated graphite were investigated. Results indicated that the Mo2C coatings were of several tens of micrometers depth in the graphite matrix. The coatings greatly improved the wettability of graphite by copper, and copper could be infiltrated into Mo2C-coated graphite matrix without external pressure. The strong interfacial bonding between copper and the graphite matrix was obtained by utilizing the mechanical interlocking within the space limitations of the graphite network. The Mo2C-modified graphite–copper samples resulted to have the average shear strength of 17±4MPa.
    Fusion Engineering and Design - FUSION ENG DES. 12/2011;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Multisite randomized clinical trials allow for increased research collaboration among investigators and expedite data collection efforts. As a result, government funding agencies typically look favorably upon this approach. As the field of complementary and alternative medicine (CAM) continues to evolve, so do increased calls for the use of more rigorous study design and trial methodologies, which can present challenges for investigators. To describe the processes involved in the coordination and management of a multisite randomized clinical trial of a CAM intervention. Key aspects related to the coordination and management of a multisite CAM randomized clinical trial are presented, including organizational and site selection considerations, recruitment concerns and issues related to data collection and randomization to treatment groups. Management and monitoring of data, as well as quality assurance procedures are described. Finally, a real world perspective is shared from a recently conducted multisite randomized clinical trial of reflexology for women diagnosed with advanced breast cancer. The use of multiple sites in the conduct of CAM-based randomized clinical trials can provide an efficient, collaborative and robust approach to study coordination and data collection that maximizes efficiency and ensures the quality of results. Multisite randomized clinical trial designs can offer the field of CAM research a more standardized and efficient approach to examine the effectiveness of novel therapies and treatments. Special attention must be given to intervention fidelity, consistent data collection and ensuring data quality. Assessment and reporting of quantitative indicators of data quality should be required.
    Contemporary clinical trials 06/2011; 32(5):620-9. · 1.51 Impact Factor

Full-text (2 Sources)

Available from
May 21, 2014