Third-wave cognitive therapy versus mentalisation-based treatment for major depressive disorder

a randomised clinical trial

Janus Christian Jakobsen, Christian Gluud, Mickey Kongerslev, Kirsten Aaskov Larsen, Per J Sørensen, Per Winkel, Theis Lange, Ulf Søgaard, Erik Simonsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVE: To compare the benefits and harms of third-wave cognitive therapy versus mentalisation-based therapy in a small sample of depressed participants.

SETTING: The trial was conducted at an outpatient psychiatric clinic for non-psychotic patients in Roskilde, Denmark.

PARTICIPANTS: 44 consecutive adult participants diagnosed with major depressive disorder.

INTERVENTIONS: 18 weeks of third-wave cognitive therapy (n=22) versus 18 weeks of mentalisation-based treatment (n=22).

OUTCOMES: The primary outcome was the Hamilton Rating Scale for Depression (HDRS) at end of treatment (18 weeks). Secondary outcomes were: remission (HDRS <8), Beck's Depression Inventory, Symptom Checklist 90 Revised and The WHO-Five Well-being Index 1999.

RESULTS: The trial inclusion lasted for about 2 years as planned but only 44 out of the planned 84 participants were randomised. Two mentalisation-based participants were lost to follow-up. The unadjusted analysis showed that third-wave participants compared with mentalisation-based participants did not differ significantly regarding the 18 weeks HDRS score (12.9 vs 17.0; mean difference -4.14; 95% CI -8.30 to 0.03; p=0.051). In the analysis adjusted for baseline HDRS score, the difference was favouring third-wave cognitive therapy (p=0.039). At 18 weeks, five of the third-wave participants (22.7%) were in remission versus none of the mentalisation-based participants (p=0.049). We recorded no suicide attempts or suicides during the intervention period in any of the 44 participants. No significant differences were found between the two intervention groups on the remaining secondary outcomes.

CONCLUSIONS: Third-wave cognitive therapy may be more effective than mentalisation-based therapy for depressive symptoms measured on the HDRS. However, more randomised clinical trials are needed to assess the effects of third-wave cognitive therapy and mentalisation-based treatment for depression.

TRIAL REGISTRATION NUMBER: Registered with Clinical Trials government identifier: NCT01070134.

OriginalsprogEngelsk
TidsskriftBMJ Open
Vol/bind4
Udgave nummer8
Sider (fra-til)1-12
ISSN2044-6055
DOI
StatusUdgivet - 19. aug. 2014

Fingeraftryk

Major Depressive Disorder
Randomized Controlled Trials
Depression
Denmark
Ambulatory Care Facilities
Checklist
Clinical Trials
Equipment and Supplies

Citer dette

Jakobsen, Janus Christian ; Gluud, Christian ; Kongerslev, Mickey ; Larsen, Kirsten Aaskov ; Sørensen, Per J ; Winkel, Per ; Lange, Theis ; Søgaard, Ulf ; Simonsen, Erik. / Third-wave cognitive therapy versus mentalisation-based treatment for major depressive disorder : a randomised clinical trial. I: BMJ Open. 2014 ; Bind 4, Nr. 8. s. 1-12.
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abstract = "OBJECTIVE: To compare the benefits and harms of third-wave cognitive therapy versus mentalisation-based therapy in a small sample of depressed participants.SETTING: The trial was conducted at an outpatient psychiatric clinic for non-psychotic patients in Roskilde, Denmark.PARTICIPANTS: 44 consecutive adult participants diagnosed with major depressive disorder.INTERVENTIONS: 18 weeks of third-wave cognitive therapy (n=22) versus 18 weeks of mentalisation-based treatment (n=22).OUTCOMES: The primary outcome was the Hamilton Rating Scale for Depression (HDRS) at end of treatment (18 weeks). Secondary outcomes were: remission (HDRS <8), Beck's Depression Inventory, Symptom Checklist 90 Revised and The WHO-Five Well-being Index 1999.RESULTS: The trial inclusion lasted for about 2 years as planned but only 44 out of the planned 84 participants were randomised. Two mentalisation-based participants were lost to follow-up. The unadjusted analysis showed that third-wave participants compared with mentalisation-based participants did not differ significantly regarding the 18 weeks HDRS score (12.9 vs 17.0; mean difference -4.14; 95{\%} CI -8.30 to 0.03; p=0.051). In the analysis adjusted for baseline HDRS score, the difference was favouring third-wave cognitive therapy (p=0.039). At 18 weeks, five of the third-wave participants (22.7{\%}) were in remission versus none of the mentalisation-based participants (p=0.049). We recorded no suicide attempts or suicides during the intervention period in any of the 44 participants. No significant differences were found between the two intervention groups on the remaining secondary outcomes.CONCLUSIONS: Third-wave cognitive therapy may be more effective than mentalisation-based therapy for depressive symptoms measured on the HDRS. However, more randomised clinical trials are needed to assess the effects of third-wave cognitive therapy and mentalisation-based treatment for depression.TRIAL REGISTRATION NUMBER: Registered with Clinical Trials government identifier: NCT01070134.",
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Third-wave cognitive therapy versus mentalisation-based treatment for major depressive disorder : a randomised clinical trial. / Jakobsen, Janus Christian; Gluud, Christian; Kongerslev, Mickey; Larsen, Kirsten Aaskov; Sørensen, Per J; Winkel, Per; Lange, Theis; Søgaard, Ulf; Simonsen, Erik.

I: BMJ Open, Bind 4, Nr. 8, 19.08.2014, s. 1-12.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Third-wave cognitive therapy versus mentalisation-based treatment for major depressive disorder

T2 - a randomised clinical trial

AU - Jakobsen, Janus Christian

AU - Gluud, Christian

AU - Kongerslev, Mickey

AU - Larsen, Kirsten Aaskov

AU - Sørensen, Per J

AU - Winkel, Per

AU - Lange, Theis

AU - Søgaard, Ulf

AU - Simonsen, Erik

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2014/8/19

Y1 - 2014/8/19

N2 - OBJECTIVE: To compare the benefits and harms of third-wave cognitive therapy versus mentalisation-based therapy in a small sample of depressed participants.SETTING: The trial was conducted at an outpatient psychiatric clinic for non-psychotic patients in Roskilde, Denmark.PARTICIPANTS: 44 consecutive adult participants diagnosed with major depressive disorder.INTERVENTIONS: 18 weeks of third-wave cognitive therapy (n=22) versus 18 weeks of mentalisation-based treatment (n=22).OUTCOMES: The primary outcome was the Hamilton Rating Scale for Depression (HDRS) at end of treatment (18 weeks). Secondary outcomes were: remission (HDRS <8), Beck's Depression Inventory, Symptom Checklist 90 Revised and The WHO-Five Well-being Index 1999.RESULTS: The trial inclusion lasted for about 2 years as planned but only 44 out of the planned 84 participants were randomised. Two mentalisation-based participants were lost to follow-up. The unadjusted analysis showed that third-wave participants compared with mentalisation-based participants did not differ significantly regarding the 18 weeks HDRS score (12.9 vs 17.0; mean difference -4.14; 95% CI -8.30 to 0.03; p=0.051). In the analysis adjusted for baseline HDRS score, the difference was favouring third-wave cognitive therapy (p=0.039). At 18 weeks, five of the third-wave participants (22.7%) were in remission versus none of the mentalisation-based participants (p=0.049). We recorded no suicide attempts or suicides during the intervention period in any of the 44 participants. No significant differences were found between the two intervention groups on the remaining secondary outcomes.CONCLUSIONS: Third-wave cognitive therapy may be more effective than mentalisation-based therapy for depressive symptoms measured on the HDRS. However, more randomised clinical trials are needed to assess the effects of third-wave cognitive therapy and mentalisation-based treatment for depression.TRIAL REGISTRATION NUMBER: Registered with Clinical Trials government identifier: NCT01070134.

AB - OBJECTIVE: To compare the benefits and harms of third-wave cognitive therapy versus mentalisation-based therapy in a small sample of depressed participants.SETTING: The trial was conducted at an outpatient psychiatric clinic for non-psychotic patients in Roskilde, Denmark.PARTICIPANTS: 44 consecutive adult participants diagnosed with major depressive disorder.INTERVENTIONS: 18 weeks of third-wave cognitive therapy (n=22) versus 18 weeks of mentalisation-based treatment (n=22).OUTCOMES: The primary outcome was the Hamilton Rating Scale for Depression (HDRS) at end of treatment (18 weeks). Secondary outcomes were: remission (HDRS <8), Beck's Depression Inventory, Symptom Checklist 90 Revised and The WHO-Five Well-being Index 1999.RESULTS: The trial inclusion lasted for about 2 years as planned but only 44 out of the planned 84 participants were randomised. Two mentalisation-based participants were lost to follow-up. The unadjusted analysis showed that third-wave participants compared with mentalisation-based participants did not differ significantly regarding the 18 weeks HDRS score (12.9 vs 17.0; mean difference -4.14; 95% CI -8.30 to 0.03; p=0.051). In the analysis adjusted for baseline HDRS score, the difference was favouring third-wave cognitive therapy (p=0.039). At 18 weeks, five of the third-wave participants (22.7%) were in remission versus none of the mentalisation-based participants (p=0.049). We recorded no suicide attempts or suicides during the intervention period in any of the 44 participants. No significant differences were found between the two intervention groups on the remaining secondary outcomes.CONCLUSIONS: Third-wave cognitive therapy may be more effective than mentalisation-based therapy for depressive symptoms measured on the HDRS. However, more randomised clinical trials are needed to assess the effects of third-wave cognitive therapy and mentalisation-based treatment for depression.TRIAL REGISTRATION NUMBER: Registered with Clinical Trials government identifier: NCT01070134.

KW - Adult

KW - Cognitive Therapy

KW - Denmark

KW - Depressive Disorder, Major

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Psychiatric Status Rating Scales

KW - Theory of Mind

KW - Treatment Outcome

KW - Journal Article

KW - Randomized Controlled Trial

KW - Research Support, Non-U.S. Gov't

U2 - 10.1136/bmjopen-2014-004903

DO - 10.1136/bmjopen-2014-004903

M3 - Journal article

VL - 4

SP - 1

EP - 12

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 8

ER -