The multi-level outcome study of psychoanalysis for chronically depressed patients with early trauma (MODE): rationale and design of an international multicenter randomized controlled trial.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_388834BD9ECE
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The multi-level outcome study of psychoanalysis for chronically depressed patients with early trauma (MODE): rationale and design of an international multicenter randomized controlled trial.
Journal
BMC psychiatry
Author(s)
Ambresin G., Leuzinger-Bohleber M., Fischmann T., Axmacher N., Hattingen E., Bansal R., Peterson B.S.
ISSN
1471-244X (Electronic)
ISSN-L
1471-244X
Publication state
Published
Issued date
16/11/2023
Peer-reviewed
Oui
Volume
23
Number
1
Pages
844
Language
english
Notes
Publication types: Multicenter Study ; Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Whether and how psychotherapies change brain structure and function is unknown. Its study is of great importance for contemporary psychotherapy, as it may lead to discovery of neurobiological mechanisms that predict and mediate lasting changes in psychotherapy, particularly in severely mentally ill patients, such as those with chronic depression. Previous studies have shown that psychoanalytic psychotherapies produce robust and enduring improvements in not only symptom severity but also personality organization in patients who have chronic depression and early life trauma, especially if therapy is delivered at a high weekly frequency.
Patients with chronic major depression and a history of early life trauma will be recruited, assessed, and treated across 3 international sites: Germany, Switzerland, and the United States. They will be randomized to one of two treatment arms: either (1) once weekly psychoanalytic psychotherapies, or (2) 3-4 times weekly psychoanalytic psychotherapies. They will have full clinical characterization as well as undergo MRI scanning at study baseline prior to randomization and again one year later. A group of matched healthy controls will undergo similar assessments and MRI scanning at the same time points to help discern whether study treatments induce brain changes toward or away from normal values. Primary study outcomes will include anatomical MRI, functional MRI, and Diffusion Tensor Imaging measures. Study hypotheses will be tested using the treatment-by-time interaction assessed in multiple general linear models with repeated measures analyses in an intent-to-treat analysis.
MODE may allow the identification of brain-based biomarkers that may be more sensitive than traditional behavioral and clinical measures in discriminating, predicting, and mediating treatment response. These findings could help to personalize care for patients who have chronic depression patients and early life trauma, and they will provide new therapeutic targets for both psychological and biological treatments for major depressive illness.
Keywords
Humans, Psychoanalysis, Depressive Disorder, Major/therapy, Diffusion Tensor Imaging, Psychotherapy/methods, Outcome Assessment, Health Care, Treatment Outcome, Chronic depression, Early trauma, Psychoanalytic psychotherapy
Pubmed
Web of science
Open Access
Yes
Create date
23/11/2023 16:32
Last modification date
08/08/2024 7:31
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