Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial
Background Depression is one of the more severe and serious health problems because of its morbidity, disabling effects and for its societal and economic burden. Despite the variety of existing pharmacological and psychological treatments, most of the cases evolve with only partial remission, relaps...
| Autores: | , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2013 |
| País: | España |
| Institución: | Universidad de Barcelona |
| Repositorio: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/52904 |
| Acceso en línea: | https://hdl.handle.net/2445/52904 |
| Access Level: | acceso abierto |
| Palabra clave: | Depressió psíquica Teràpia cognitiva Mental depression Cognitive therapy |
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Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trialFeixas i Viaplana, GuillemBados López, ArturoGarcía Grau, EugeniMontesano del Campo, AdriánDada, GloriaCompañ, VictoriaAguilera, María del CarmenSalla Martínez, MartaSoldevilla Alberti, Joan MiquelTrujillo, AdrianaPaz, ClaraBotella, LluísCorbella, SergiSaúl Gutiérrez, Luis ÁngelCañete Crespillo, JosepGasol, MiquelIbarra, MontserratMedeiros-Ferreira, LeticiaSoriano, JoséRibeiro, EugéniaDepressió psíquicaTeràpia cognitivaMental depressionCognitive therapyBackground Depression is one of the more severe and serious health problems because of its morbidity, disabling effects and for its societal and economic burden. Despite the variety of existing pharmacological and psychological treatments, most of the cases evolve with only partial remission, relapse and recurrence. Cognitive models have contributed significantly to the understanding of unipolar depression and its psychological treatment. However, success is only partial and many authors affirm the need to improve those models and also the treatment programs derived from them. One of the issues that requires further elaboration is the difficulty these patients experience in responding to treatment and in maintaining therapeutic gains across time without relapse or recurrence. Our research group has been working on the notion of cognitive conflict viewed as personal dilemmas according to personal construct theory. We use a novel method for identifying those conflicts using the repertory grid technique (RGT). Preliminary results with depressive patients show that about 90% of them have one or more of those conflicts. This fact might explain the blockage and the difficult progress of these patients, especially the more severe and/or chronic. These results justify the need for specific interventions focused on the resolution of these internal conflicts. This study aims to empirically test the hypothesis that an intervention focused on the dilemma(s) specifically detected for each patient will enhance the efficacy of cognitive behavioral therapy (CBT) for depression. Design A therapy manual for a dilemma-focused intervention will be tested using a randomized clinical trial by comparing the outcome of two treatment conditions: combined group CBT (eight, 2-hour weekly sessions) plus individual dilemma-focused therapy (eight, 1-hour weekly sessions) and CBT alone (eight, 2-hour group weekly sessions plus eight, 1-hour individual weekly sessions). Method Participants are patients aged over 18 years meeting diagnostic criteria for major depressive disorder or dysthymic disorder, with a score of 19 or above on the Beck depression inventory, second edition (BDI-II) and presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct) as assessed using the RGT. The BDI-II is the primary outcome measure, collected at baseline, at the end of therapy, and at 3- and 12-month follow-up; other secondary measures are also used. Discussion We expect that adding a dilemma-focused intervention to CBT will increase the efficacy of one of the more prestigious therapies for depression, thus resulting in a significant contribution to the psychological treatment of depression. Trial registration ISRCTN92443999; ClinicalTrials.gov Identifier: NCT01542957.BioMed Central2013info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/52904Articles publicats en revistes (Psicologia Clínica i Psicobiologia)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaEspañolReproducció del document publicat a: http://dx.doi.org/10.1186/1745-6215-14-144Trials, 2013, vol. 14, num. 144http://dx.doi.org/10.1186/1745-6215-14-144cc-by (c) Feixas i Viaplana, Guillem et al., 2013http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/529042026-05-27T06:46:51Z |
| dc.title.none.fl_str_mv |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial |
| title |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial |
| spellingShingle |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial Feixas i Viaplana, Guillem Depressió psíquica Teràpia cognitiva Mental depression Cognitive therapy |
| title_short |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial |
| title_full |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial |
| title_fullStr |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial |
| title_full_unstemmed |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial |
| title_sort |
Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial |
| dc.creator.none.fl_str_mv |
Feixas i Viaplana, Guillem Bados López, Arturo García Grau, Eugeni Montesano del Campo, Adrián Dada, Gloria Compañ, Victoria Aguilera, María del Carmen Salla Martínez, Marta Soldevilla Alberti, Joan Miquel Trujillo, Adriana Paz, Clara Botella, Lluís Corbella, Sergi Saúl Gutiérrez, Luis Ángel Cañete Crespillo, Josep Gasol, Miquel Ibarra, Montserrat Medeiros-Ferreira, Leticia Soriano, José Ribeiro, Eugénia |
| author |
Feixas i Viaplana, Guillem |
| author_facet |
Feixas i Viaplana, Guillem Bados López, Arturo García Grau, Eugeni Montesano del Campo, Adrián Dada, Gloria Compañ, Victoria Aguilera, María del Carmen Salla Martínez, Marta Soldevilla Alberti, Joan Miquel Trujillo, Adriana Paz, Clara Botella, Lluís Corbella, Sergi Saúl Gutiérrez, Luis Ángel Cañete Crespillo, Josep Gasol, Miquel Ibarra, Montserrat Medeiros-Ferreira, Leticia Soriano, José Ribeiro, Eugénia |
| author_role |
author |
| author2 |
Bados López, Arturo García Grau, Eugeni Montesano del Campo, Adrián Dada, Gloria Compañ, Victoria Aguilera, María del Carmen Salla Martínez, Marta Soldevilla Alberti, Joan Miquel Trujillo, Adriana Paz, Clara Botella, Lluís Corbella, Sergi Saúl Gutiérrez, Luis Ángel Cañete Crespillo, Josep Gasol, Miquel Ibarra, Montserrat Medeiros-Ferreira, Leticia Soriano, José Ribeiro, Eugénia |
| author2_role |
author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Depressió psíquica Teràpia cognitiva Mental depression Cognitive therapy |
| topic |
Depressió psíquica Teràpia cognitiva Mental depression Cognitive therapy |
| description |
Background Depression is one of the more severe and serious health problems because of its morbidity, disabling effects and for its societal and economic burden. Despite the variety of existing pharmacological and psychological treatments, most of the cases evolve with only partial remission, relapse and recurrence. Cognitive models have contributed significantly to the understanding of unipolar depression and its psychological treatment. However, success is only partial and many authors affirm the need to improve those models and also the treatment programs derived from them. One of the issues that requires further elaboration is the difficulty these patients experience in responding to treatment and in maintaining therapeutic gains across time without relapse or recurrence. Our research group has been working on the notion of cognitive conflict viewed as personal dilemmas according to personal construct theory. We use a novel method for identifying those conflicts using the repertory grid technique (RGT). Preliminary results with depressive patients show that about 90% of them have one or more of those conflicts. This fact might explain the blockage and the difficult progress of these patients, especially the more severe and/or chronic. These results justify the need for specific interventions focused on the resolution of these internal conflicts. This study aims to empirically test the hypothesis that an intervention focused on the dilemma(s) specifically detected for each patient will enhance the efficacy of cognitive behavioral therapy (CBT) for depression. Design A therapy manual for a dilemma-focused intervention will be tested using a randomized clinical trial by comparing the outcome of two treatment conditions: combined group CBT (eight, 2-hour weekly sessions) plus individual dilemma-focused therapy (eight, 1-hour weekly sessions) and CBT alone (eight, 2-hour group weekly sessions plus eight, 1-hour individual weekly sessions). Method Participants are patients aged over 18 years meeting diagnostic criteria for major depressive disorder or dysthymic disorder, with a score of 19 or above on the Beck depression inventory, second edition (BDI-II) and presenting at least one cognitive conflict (implicative dilemma or dilemmatic construct) as assessed using the RGT. The BDI-II is the primary outcome measure, collected at baseline, at the end of therapy, and at 3- and 12-month follow-up; other secondary measures are also used. Discussion We expect that adding a dilemma-focused intervention to CBT will increase the efficacy of one of the more prestigious therapies for depression, thus resulting in a significant contribution to the psychological treatment of depression. Trial registration ISRCTN92443999; ClinicalTrials.gov Identifier: NCT01542957. |
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2013 |
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2013 |
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info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
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https://hdl.handle.net/2445/52904 |
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Español |
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Español |
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Reproducció del document publicat a: http://dx.doi.org/10.1186/1745-6215-14-144 Trials, 2013, vol. 14, num. 144 http://dx.doi.org/10.1186/1745-6215-14-144 |
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cc-by (c) Feixas i Viaplana, Guillem et al., 2013 http://creativecommons.org/licenses/by/3.0/es info:eu-repo/semantics/openAccess |
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cc-by (c) Feixas i Viaplana, Guillem et al., 2013 http://creativecommons.org/licenses/by/3.0/es |
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openAccess |
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BioMed Central |
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BioMed Central |
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Articles publicats en revistes (Psicologia Clínica i Psicobiologia) reponame:Dipòsit Digital de la UB instname:Universidad de Barcelona |
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