REVAMP Follow-up Study

REVAMP 后续研究

• 批准号: 7447399
• 负责人: FRANCISCO A MORENO
• 金额: $ 5.97万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-24 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7447399
• 关键词: Accounting; Acute; Address; Adverse effects; Aftercare; Algorithms; American; Behavioral; Chronic; Clinical Management; Cognitive; Cognitive Therapy; Condition; Consent; Data; Depressed mood; Disease remission; Educational process of instructing; Follow-Up Studies; Funding; Goals; Group Psychotherapy; Guidelines; Long-Term Effects; Maintenance; Major Depressive Disorder; Mediating; Mental Depression; National Institute of Mental Health; Outcome; Patients; Pharmaceutical Preparations; Pharmacotherapy; Phase; Principal Investigator; Problem Solving; Psychotherapy; Randomized; Rate; Recurrence; Relapse; Research; Research Personnel; Resistance; Risk; Sampling; Site; Social Adjustment; Social Functioning; Social Problems; Staging; Symptoms; Systems Analysis; Testing; Time; Week; Withholding Treatment; chronic depression; compliance behavior; depressive symptoms; falls; follow-up; programs; response; skills

DESCRIPTION (provided by applicant): The goal of the ongoing NIMH funded multi-site study entitled "Research Evaluating the Effect of Augmenting Medication with Psychotherapy" (REVAMP) is to investigate psychotherapeutic strategies for treating chronic forms of major depression unresponsive to medication alone. Patients (n = 909) are treated initially with one of several pharmacologic strategies, as guided by a staged algorithm. Those who do not remit after up to 12 weeks of treatment (estimated n = 500) receive the next algorithm-guided pharmacotherapy. In addition they are randomized to Cognitive Behavioral Analysis System of Psychotherapy (CBASP), Supportive Psychotherapy (SP), or Clinical Management (CM). At exit from this 12-week randomized therapy trial all consenting patients enter a 24-month naturalistic follow-up to investigate the durability of the acute approaches in keeping patients well. It is hypothesized that patients who received augmentation with CBASP in addition to switching medication will have better long-term outcomes (e.g., more time in remission, lower symptom ratings, better social adjustment) than patients receiving a medication switch alone, and patients who received SP augmentation will fall in between. We also hope to test whether the long-term effects of CBASP are mediated by teaching patients more effective social problem-solving skills. We now are submitting a competing continuation application to complete the final 3 years of the follow-up. Some prior studies have showed enduring effects of psychotherapy in depressed patients (although not in chronic forms of MOD), but other studies have failed to find such an effect, including the NIMH Collaborative Treatment Study. This follow-up study will address the important question of whether augmentation with 12 weeks of CBASP, a therapy developed specifically for chronic depression, leads to enduring effects in a chronic sample over that provided by pharmacotherapy alone or in combination with a less specific form of psychotherapy.

描述（由申请人提供）：正在进行的 NIMH 资助的多中心研究，题为“研究评估心理治疗增强药物的效果”（REVAMP），其目标是研究治疗对单独药物治疗无反应的慢性重度抑郁症的心理治疗策略。患者 (n = 909) 最初按照分阶段算法的指导，采用几种药物策略之一进行治疗。治疗长达 12 周后仍未缓解的患者（估计 n = 500）将接受下一个算法指导的药物治疗。此外，他们还被随机分配接受心理治疗认知行为分析系统（CBASP）、支持性心理治疗（SP）或临床管理（CM）。在这项为期 12 周的随机治疗试验结束后，所有同意的患者都会进入为期 24 个月的自然随访，以研究急性治疗方法在保持患者健康方面的持久性。据推测，与仅接受药物转换的患者相比，除了转换药物外还接受 CBASP 增强治疗的患者将具有更好的长期结果（例如，更长的缓解时间、更低的症状评级、更好的社会适应）。 SP增强介于两者之间。我们还希望测试 CBASP 的长期影响是否可以通过教授患者更有效的社会问题解决技能来调节。我们现在正在提交竞争性延续申请，以完成最后 3 年的后续工作。之前的一些研究已经表明心理治疗对抑郁症患者有持久的效果（尽管不是慢性 MOD），但其他研究未能发现这种效果，包括 NIMH 协作治疗研究。这项后续研究将解决一个重要问题，即 CBASP（一种专为慢性抑郁症开发的疗法）的 12 周增强是否会比单独的药物疗法或与不太具体的形式的组合疗法在慢性样本中产生持久的效果。心理治疗。