Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial
Open Access
- 30 October 2012
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Psychiatry
- Vol. 12 (1), 182
- https://doi.org/10.1186/1471-244x-12-182
Abstract
Background: A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. However, there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists. The present article describes the protocol of a study that will examine the relative efficacy, the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for inpatients with unipolar depression.Methods/Design: The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions). Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention–to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher.Discussion: Despite the large number of studies on treatment of depression, there is a clear lack of controlled research in inpatient psychotherapy during the acute phase of a major depressive episode. Research on brief therapy is important to take into account current short lengths of stay in psychiatry. The current study has the potential to scientifically inform appropriate inpatient treatment. This study is the first to address the issue of the economic evaluation of inpatient psychotherapy.Trial registration: Australian New Zealand Clinical Trial Registry (ACTRN12612000909820)Keywords
This publication has 58 references indexed in Scilit:
- A letter from America: rescuing inpatient psychiatryEvidence-Based Mental Health, 2008
- Efficacy of Interpersonal Psychotherapy plus pharmacotherapy in chronically depressed inpatientsJournal of Affective Disorders, 2008
- The Operationalized Psychodynamic Diagnostics System: Clinical Relevance, Reliability and ValidityPsychopathology, 2007
- Reducing relapse and recurrence in unipolar depression: A comparative meta-analysis of cognitive-behavioral therapy's effects.Journal of Consulting and Clinical Psychology, 2007
- Length of first admission and treatment outcome in patients with unipolar depressionJournal of Affective Disorders, 2006
- Adherence to guidelines for treatment of depression in in-patientsThe British Journal of Psychiatry, 2005
- The psychotherapy dose-response effect and its implications for treatment delivery services.Clinical Psychology: Science and Practice, 2002
- Dose-effect relations in time-limited psychotherapy for depression.Journal of Consulting and Clinical Psychology, 1996
- Inventory of interpersonal problems: Psychometric properties and clinical applications.Journal of Consulting and Clinical Psychology, 1988
- A New Depression Scale Designed to be Sensitive to ChangeThe British Journal of Psychiatry, 1979