TY - JOUR

T1 - Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression

T2 - randomized controlled trial design and protocol

AU - Bockting, Claudi LH

AU - Kok, Gemma D

AU - van der Kamp, Lillian

AU - Smit, Filip

AU - van Valen, Evelien

AU - Schoevers, Robert

AU - van Marwijk, Harm

AU - Cuijpers, Pim

AU - Riper, Heleen

AU - Dekker, Jack

AU - Beck, Aaron T.

N1 - Funding Information: The research is funded by ZONMW: The Netherlands association for Health research and Development, program Disease management, Chronic diseases (project number: 300020014] to CLH Bockting (Principal Investigator) Associate professor of Clinical Psychology, Groningen University, Groningen, The Netherlands. The Netherlands Organization for Scientific Research (NWO) funded this manuscript.

PY - 2011/1/14

Y1 - 2011/1/14

N2 - Background: Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The major contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Accordingly, efforts to reduce the disabling effects of this chronic condition should shift to preventing recurrence, especially in patients at high risk of recurrence. Given its high prevalence and the fact that interventions are necessary during the remitted phase, new approaches are needed to prevent relapse in depression.Methods/design: The best established effective and available psychological intervention is cognitive therapy. However, it is costly and not available for most patients. Therefore, we will compare the effectiveness and cost-effectiveness of self-management supported by online CT accompanied by SMS based tele-monitoring of depressive symptomatology, i.e. Mobile Cognitive Therapy (M-CT) versus treatment as us usual (TAU). Remitted patients (n = 268) with at least two previous depressive episodes will be recruited and randomized over (1) M-CT in addition to TAU versus (2) TAU alone, with follow-ups at 3, 12, and 24 months. Randomization will be stratified for number of previous episodes and type of treatment as usual. Primary outcome is time until relapse/recurrence over 24 months using DSM-IV-TR criteria as assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). For the economic evaluation the balance between costs and health outcomes will be compared across strategies using a societal perspective.Discussion: Internet-based interventions might be helpful in empowering patients to become their own disease managers in this lifelong recurrent disorder. This is, as far as we are aware of, the first study that examines the (cost) effectiveness of an E-mental health program using SMS monitoring of symptoms with therapist support to prevent relapse in remitted recurrently depressed patients.Trial registration: Netherlands Trial Register (NTR): NTR2503.

AB - Background: Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The major contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Accordingly, efforts to reduce the disabling effects of this chronic condition should shift to preventing recurrence, especially in patients at high risk of recurrence. Given its high prevalence and the fact that interventions are necessary during the remitted phase, new approaches are needed to prevent relapse in depression.Methods/design: The best established effective and available psychological intervention is cognitive therapy. However, it is costly and not available for most patients. Therefore, we will compare the effectiveness and cost-effectiveness of self-management supported by online CT accompanied by SMS based tele-monitoring of depressive symptomatology, i.e. Mobile Cognitive Therapy (M-CT) versus treatment as us usual (TAU). Remitted patients (n = 268) with at least two previous depressive episodes will be recruited and randomized over (1) M-CT in addition to TAU versus (2) TAU alone, with follow-ups at 3, 12, and 24 months. Randomization will be stratified for number of previous episodes and type of treatment as usual. Primary outcome is time until relapse/recurrence over 24 months using DSM-IV-TR criteria as assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). For the economic evaluation the balance between costs and health outcomes will be compared across strategies using a societal perspective.Discussion: Internet-based interventions might be helpful in empowering patients to become their own disease managers in this lifelong recurrent disorder. This is, as far as we are aware of, the first study that examines the (cost) effectiveness of an E-mental health program using SMS monitoring of symptoms with therapist support to prevent relapse in remitted recurrently depressed patients.Trial registration: Netherlands Trial Register (NTR): NTR2503.

KW - Health sciences

KW - Psychology

UR - http://www.scopus.com/inward/record.url?scp=78651361776&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/b43874f8-ddc7-3b93-860e-336cedf2503b/

U2 - 10.1186/1471-244X-11-12

DO - 10.1186/1471-244X-11-12

M3 - Journal articles

C2 - 21235774

VL - 11

JO - BMC Psychiatry

JF - BMC Psychiatry

SN - 1471-244X

M1 - 12

ER -