The overall aim of this research is to further our knowledge of the best treatments for mood disorders. The more specific goal of this project is to determine the most effective post-hospital treatments for depressed inpatients. Despite their high morbidity, poor response to usual treatments, and high treatment costs, depressed inpatients have been markedly under-studied in clinical trials. While previous studies have suggested that combined psychosocial + pharmacological treatment maybe the most efficacious treatment, these studies have been limited in several respects and have not explored the parameters of the most effective combined treatments. To address these issues, we propose to conduct a clinical trial investigating the efficacy of combined psychosocial + medication treatments for post-discharge treatment for depressed inpatients. In addition to the basic comparison of component increases the efficacy of combined treatment. Thus, we propose to recruit 150 hospitalized patients with major depression and compare the efficacy of three treatment conditions: 1) Pharmacotherapy Alone (medication + clinical management), 2) Combined Individual (cognitive therapy + medication + clinical management, and 3) Combined Individual + Family (cognitive therapy + family therapy + medication + clinical management). Patients will be recruited while in the hospital and treated for 24 weeks on an outpatient basis. Responders to acute treatment will receive an additional 8 weeks of continuation/maintenance treatment. We hypothesize the following: 1. Patients who received combined treatment will have a better response to treatment than patients who receive pharmacotherapy alone (Pharmacotherapy Alone vs. Combined Individual, Combined Individual + Family). 2. Patients who receive additional individual therapy + family therapy will respond better than patients who receive additional therapy only (Combined Individual vs. Combined Individual + Family).

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
7R01MH058866-04
Application #
6711467
Study Section
Special Emphasis Panel (ZMH1-CRB-B (05))
Program Officer
Niederehe, George T
Project Start
2000-02-15
Project End
2005-01-31
Budget Start
2002-10-01
Budget End
2003-01-31
Support Year
4
Fiscal Year
2002
Total Cost
$194,445
Indirect Cost
Name
Butler Hospital (Providence, RI)
Department
Type
DUNS #
069847804
City
Providence
State
RI
Country
United States
Zip Code
02906
Wedig, Michelle M; Weinstock, Lauren M; Epstein-Lubow, Gary et al. (2013) Predictors of depressive symptoms at hospital discharge in patients with major depressive disorder. Int J Psychiatry Clin Pract 17:144-7
Febres, Jeniimarie; Rossi, Rita; Gaudiano, Brandon A et al. (2011) Differential relationship between depression severity and patients' perceived family functioning in women versus in men. J Nerv Ment Dis 199:449-53
Gibb, Brandon E; Andover, Margaret S; Miller, Ivan W (2009) Depressive characteristics of adult psychiatric inpatients with a history of multiple versus one or no suicide attempts. Depress Anxiety 26:568-74
Andover, Margaret S; Gibb, Brandon E; Miller, Ivan W (2008) Time to emergence of severe suicidal ideation among psychiatric patients as a function of suicide attempt history. Compr Psychiatry 49:6-12
Andover, Margaret S; Zlotnick, Caron; Miller, Ivan W (2007) Childhood physical and sexual abuse in depressed patients with single and multiple suicide attempts. Suicide Life Threat Behav 37:467-74
Gaudiano, Brandon A; Miller, Ivan W (2007) Dysfunctional cognitions in hospitalized patients with psychotic versus nonpsychotic major depression. Compr Psychiatry 48:357-65
Miller, Ivan W; Keitner, Gabor I; Ryan, Christine E et al. (2005) Treatment matching in the posthospital care of depressed patients. Am J Psychiatry 162:2131-8
Beevers, Christopher G; Miller, Ivan W (2005) Unlinking negative cognition and symptoms of depression: evidence of a specific treatment effect for cognitive therapy. J Consult Clin Psychol 73:68-77
Gaudiano, Brandon A; Beevers, Christopher G; Miller, Ivan W (2005) Differential response to combined treatment in patients with psychotic versus nonpsychotic major depression. J Nerv Ment Dis 193:625-8
Gibb, Brandon E; Alloy, Lauren B; Abramson, Lyn Y et al. (2004) Cognitive vulnerability to depression: a taxometric analysis. J Abnorm Psychol 113:81-9

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