Specific psychotherapy of the longer-lasting depression (CBASP)
DFG-sponsored F-MRT Bonn-Heidelberg-study I
Neural mechanisms and predictors of the improvement of affect regulation through psychotherapy in outpatient patients with chronic depression
At 20-35% of patients with depressive disorder there is a chronic course, which usually responds unsatisfactorily to a pharmacological treatment and to the evidence-based psychotherapeutic treatment procedures for episodic depression. Chronically depressed patients often differ from episodic depressed patients by an early onset of disease and traumatic childhood experiences and are more severely impaired in their psychosocial functional level. The specific psychotherapy for chronic depression was developed against this background and is already evaluated. The cognitive analysis System of psychotherapeutic (CBASP), is based on the assumption that in chronically depressed patients there is a profound disorder regarding on the one hand the social cognition about affects and motives of other people and on the other hand the perception of the consequences of their behavior on others. Accordingly, CBASP explicitly aims to train capacity for empathy and the recognition of behaviour-consequence relationships. It is investigated whether CBASP therapy actually has an effect on specific neural mechanisms, i.e. a change in the function of social cognition networks, i.e. the mentalization of other people's feelings and the recognition of social consequences of its own behaviour, or whether the same functional changes occur under another method of therapy (SYSP: System of Supportive Psychotherapy). For this purpose, functional differences in the function of neural networks of social cognition, affect regulation and the reward system are compared in two groups of chronically depressed patients before and after therapeutic intervention with CBASP and SYSP. The treatment takes place in a randomized, controlled studye, which is carried out in 5 German university treatment centres.
Project manager Bonn: Prof. Dr. Dr. H. Walter, Priv. Doz. Dr. Med. Dieter Schoepf
Contact: Priv. Doz. Dr. Med. Dieter Schoepf
DFG-sponsored F-MRT Bonn-Heidelberg-Study II
Neural mechanisms and predictors of the improvement of affect regulation in outpatient patients with chronic depression vs. Patients with episodic running depression
It is examined with the same paradigms, whether the chronic and the episodic depression are actually different from each other in brain functional changes. For this purpose, episodic and chronically depressed patients as well as healthy controls will be investigated with the help of functional magnetic resonance tomography (fMRI). The four planned experimental paradigms have already been established in previous studies. There is no treatment in the group of episodic occurring depression. The investigations take place at the University Hospital in Bonn and the University Hospital in Heidelberg.
Project manager Bonn: Prof. Dr. Dr. H. Walter, Priv. doz. Dr. med. Dieter Schoepf
Contact: Priv. Doz. Dr. med. Dieter Schoepf
Lundbeck-sponsored Freiburg-Bonn Study
Differential response to Cognitive behavioral analysis System of Psychotherapy (CBASP) versus Escitalopram in chronic depression with and without early trauma
The clinical study examines treatment methods of major chronic depression in outpatient conditions at the University Hospital Freiburg and Bonn. Treatment places are available for 60 patients aged between 18 and 65 years of age who suffer from major chronic depression. Of the 60 study participants, in the beginning 30 are treated with the cognitive behavioral Analysis System of Psychotherapy (CBASP), an innovative psychotherapy procedure developed specifically for the treatment of chronic depression. The 30 other study participants are initially treated with the antidepressant Escitalopram as well as short medical consultations. All study participants are randomized for the treatment procedure. The actual treatment is open. The primary target criterion is the change in the MADRS, a common depression scale. The evaluation is carried out by a blinded rater. The study participants are first treated for 8 weeks either with the CBASP or with Escitalopram and short medical consultations. If at this time the MADRS value has not improved by at least 20%, the participants will be treated for a further 20 weeks with a combination of both treatment procedures. In the case of clinical improvement of more than 20%, the respective treatment procedure will be continued as monotherapy for another 20 weeks. In addition, the study participants are asked to participate in optional additional examinations (F-MRI, genetic examination, pharmacological examination).
Project manager Bonn: Priv. Doz. Dr. med. Dieter Schoepf, Prof. Dr. Dr. H. Walter
Contact: Priv. Doz. Dr. med. Dieter Schoepf