title: Psychoanalytic and cognitive-behavior therapy of chronic depression: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Despite limited effectiveness of short-term psychotherapy for chronic depression, there is a lack of trials of long-term psychotherapy. Our study is the first to determine the effectiveness of controlled long-term psychodynamic and cognitive-behavioral (CBT) treatments and to assess the effects of preferential vs. randomized assessment.
  
  
  METHODS
  Patients are assigned to treatment according to their preference or randomized (if they have no clear preference). Up to 80 sessions of psychodynamic or psychoanalytically oriented treatments (PAT) or up to 60 sessions of CBT are offered during the first year in the study. After the first year, PAT can be continued according to the 'naturalistic' usual method of treating such patients within the system of German health care (normally from 240 up to 300 sessions over two to three years). CBT therapists may extend their treatment up to 80 sessions, but focus mainly maintenance and relapse prevention. We plan to recruit a total of 240 patients (60 per arm). A total of 11 assessments are conducted throughout treatment and up to three years after initiation of treatment. The primary outcome measures are the Quick Inventory of Depressive Symptoms (QIDS, independent clinician rating) and the Beck Depression Inventory (BDI) after the first year.
  
  
  CONCLUSIONS
  We combine a naturalistic approach with randomized controlled trials(RCTs)to investigate how effectively chronic depression can be treated on an outpatient basis by the two forms of treatment reimbursed in the German healthcare system and we will determine the effects of treatment preference vs. randomization.
  
  
  BACKGROUND
  http://www.controlled-trials.com/ISRCTN91956346.
authors: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. manfred.beutel@unimedizin-mainz.de
authors: Manfred E
authors: ME
authors: Beutel
authors: Marianne
authors: M
authors: Leuzinger-Bohleber
authors: Bernhard
authors: B
authors: Rüger
authors: Ulrich
authors: U
authors: Bahrke
authors: Alexa
authors: A
authors: Negele
authors: Antje
authors: A
authors: Haselbacher
authors: Georg
authors: G
authors: Fiedler
authors: Wolfram
authors: W
authors: Keller
authors: Martin
authors: M
authors: Hautzinger
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005858:Germany; D006801:Humans; D008875:Middle Aged; D057240:Patient Preference; D011569:Psychiatric Status Rating Scales; D011575:Psychoanalytic Therapy; D012008:Recurrence; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult