Although studies of the treatment of major affective disorders have become commonplace, this is not the case for all types of mood disturbances. The minor affective disorders (DSM-III: dysthymic disorder; Research Diagnostic Criteria: chronic and intermittent minor affective disorder) appear far more frequent than the major disorders, but little is known about their treatment. However, psychological research by such investigators as Beck, Lewinsohn, Seligman and Rehm suggests that these depressions may be associated with a variety of cognitive and behavioral dysfunctions: poor interpersonal skills, unassertiveness, cognitive distortion of self-worth, etc. The present proposal will evaluate a psychological treatment package of social skills training for treatment of outpatients with minor affective disorder. This package consists of a number of procedures (e.g., modeling, roleplaying, corrective feedback, and social reinforcement) designed to aid patients improve (1) their interpersonal abilities in a wide range of social situations, (2) their social sensitivity, by providing training in recognizing and evaluating social cues, and (3) their standards of self-evaluation, by providing subjects with training in the use of realistic criteria for such judgments. In order to provide a meaningful test of social skills training with these depressed outpatients, a commonly used treatment procedure was selected--administration of the tricyclic antidepressant imipramine. Subjects will be assigned to one of four conditions for 12 weeks of treatment: 1) social skills training plus placebo, 2) social skills training plus imipramine, 3) P.R.N. crisis intervention plus placebo, 4) P.R.N. crisis intervention plus imipramine. The P.R.N. condition will serve as a minimal-contact control. Thereafter subjects will receive six months of maintenance treatment in their respective conditions and will be followed-up for an additional twelve months. Multimodal assessments of depression and social functioning will occur at six points from baseline through follow-up. Examination of self-report, behavioral, cognitive, and clinical rating data will permit the investigation of the effects of social skills training in comparison to drug treatment and minimal contact.
| Yadalam, K G; Simpson, G M (1988) Changing from oral to depot fluphenazine. J Clin Psychiatry 49:346-8 |
