Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
Trials. 2023 Sep 22;24(1):602. doi: 10.1186/s13063-023-07629-x.
Due to the growing gap between the demand and supply of therapeutic services for people suffering from depression, with this study, we are investigating the effectiveness and factors of influence of new approaches in group treatments for depression. Two previous studies have already identified bouldering psychotherapy (BPT) as an effective option. It combines psychotherapeutic interventions with action- and body-oriented bouldering exercises. Mental model therapy (MMT) is a new cognitive-behavioral approach for treating depression. It focuses on identifying cognitive distortions, biases in decision making, and false assumptions and aims to correct and replace them with useful mental models. We aim to investigate the effectiveness of the interventions compared with a control group (CG) and to assess the factors of influence in a mixed methods approach.
The study is being conducted as a randomized controlled intervention trial. Adult participants with unipolar depression are being randomized into three groups (BPT, MMT, or CG), and the first two groups are undergoing a 10-week treatment phase. CG follows their individual standard treatment as usual. A priori power analysis revealed that about 120 people should be included to capture a moderate effect. The primary outcome of the study is depression rated with the Montgomery and Asberg Depression Rating Scale (MADRS) before (t0), directly after (t1), and 12 months after the intervention phase (t2). Data are being collected via questionnaires, computer-assisted video interviews, and physical examinations. The primary hypotheses will be statistically analyzed by mixed model ANOVAs to compare the three groups over time. For secondary outcomes, further multivariate methods (e.g., mixed model ANOVAs and regression analyses) will be conducted. Qualitative data will be evaluated on the basis of the qualitative thematic analysis.
This study is investigating psychological and physical effects of BPT and MMT and its factors of influence on outpatients suffering from depression compared with a CG in a highly naturalistic design. The study could therefore provide insight into the modes of action of group therapy for depression and help to establish new short-term group treatments. Methodological limitations of the study might be the clinical heterogeneity of the sample and confounding effects due to simultaneous individual psychotherapy.
ISRCTN, ISRCTN12347878. Registered 28 March 2022, https://www.isrctn.com/ISRCTN12347878 .
由于治疗抑郁症患者的治疗服务需求和供应之间的差距越来越大，本研究旨在调查团体治疗中针对抑郁症的新方法的有效性和影响因素。之前的两项研究已经确定了攀岩心理疗法（BPT）是一种有效的选择。它将心理治疗干预与行动导向和身体导向的攀岩运动相结合。心理模型治疗（MMT）是一种新的认知行为治疗抑郁症的方法。它专注于识别认知扭曲、决策偏见和错误假设，并旨在用有用的心理模型纠正和取代它们。我们旨在通过混合方法评估来调查干预措施与对照组（CG）的有效性，并评估影响因素。
该研究是一项随机对照干预试验。患有单相抑郁症的成年参与者被随机分为三组（BPT、MMT 或 CG），前两组接受为期 10 周的治疗阶段。CG 按照各自的标准治疗照常进行。预先的功效分析显示，大约需要 120 人参与才能捕捉到中等效应。该研究的主要结果是用蒙哥马利和阿斯伯格抑郁评定量表（MADRS）在干预前（t0）、直接后（t1）和干预阶段后 12 个月（t2）评定抑郁症。数据通过问卷调查、计算机辅助视频访谈和体检收集。主要假设将通过混合模型方差分析进行统计分析，以比较三组随时间的变化。对于次要结果，将进一步进行多元方法（例如混合模型方差分析和回归分析）。定性数据将基于定性主题分析进行评估。
本研究在高度自然主义的设计中，调查了 BPT 和 MMT 的心理和生理影响及其与 CG 相比对门诊抑郁症患者的影响因素。因此，该研究可以深入了解团体治疗抑郁症的作用模式，并有助于建立新的短期团体治疗方法。研究的方法学局限性可能是样本的临床异质性和同时进行的个体心理治疗的混杂效应。
ISRCTN，ISRCTN12347878。于 2022 年 3 月 28 日注册，https://www.isrctn.com/ISRCTN12347878。
