60 patients with chronic major depressive disorder according to DSM-IV will be included into the study. Patients will be randomized to receive an open treatment either with CBASP, a psychotherapy for chronic depression, or pharmacological treatment with Escitalopram for 28 weeks.
The psychotherapeutic treatment with CBASP will be conducted in 2 weekly sessions for the first 4 weeks, one per week thereafter until week 9, followed by one session every 2 weeks for 20 more weeks. The starting dose for Escitalopram will be 10 mg/d for one week and will be increased to 20 mg/d after one week. The dosage can be reduced to 10 mg/d after day 7 to improve tolerance. Th MADRS-scale is the primary outcome measure; ratings will be performed by a blinded rater. If there is no improvement (reduction of less than 20% of the MADRS), patients will be crossed over in terms of adding the other treatment at week 8. Study patients will be asked to participate in fMRI, genetic and pharmacological substudies.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
specific psychotherapy for chronic depression
Escitalopram 10-20 mg once daily for the treatment of depression in combination with clinical management
University of Bonn, Dept. of Psychiatry
Bonn, Germany
RECRUITINGUniversity of Freiburg, Dept. of Psychiatry and Psychotherapy
Freiburg im Breisgau, Germany
RECRUITINGDepressive symptomatology after 8 weeks after randomization as measured by the MADRS
Time frame: 8 weeks
Depressive symptoms and remission 28 weeks after randomization; social, interpersonal and work function 28 weeks after randomization
Time frame: 28 weeks after ranomization
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