Staying well after depression: trial design and protocol

<p>Abstract</p> <p>Background</p> <p>Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group.</p> <p>Methods/Design</p> <p>This trial compares Mindfulness-Based Cognitive Therapy (MBCT), a novel form of treatment combining mindfulness meditation and cognitive therapy for depression, with both Cognitive Psycho-Education (CPE), an equally plausible cognitive treatment but without meditation, and treatment as usual (TAU). It will test whether MBCT reduces the risk of relapse in recurrently depressed patients and the incidence of suicidal symptoms in those with a history of suicidality who do relapse. It recruits participants, screens them by telephone for main inclusion and exclusion criteria and, if they are eligible, invites them to a pre-treatment session to assess eligibility in more detail. This trial allocates eligible participants at random between MBCT and TAU, CPE and TAU, and TAU alone in a ratio of 2:2:1, stratified by presence of suicidal ideation or behaviour and current anti-depressant use. We aim to recruit sufficient participants to allow for retention of 300 following attrition. We deliver both active treatments in groups meeting for two hours every week for eight weeks. We shall estimate effects on rates of relapse and suicidal symptoms over 12 months following treatment and assess clinical status immediately after treatment, and three, six, nine and twelve months thereafter.</p> <p>Discussion</p> <p>This will be the first trial of MBCT to investigate whether MCBT is effective in preventing relapse to depression when compared with a control psychological treatment of equal plausibility; and to explore the use of MBCT for the most severe recurrent depression - that in people who become suicidal when depressed.</p> <p>Trial Registration</p> <p>Current Controlled Trials: ISRCTN97185214.</p

Exploring Memory Interventions in Depression through Lifelogging Lens

Depression is a major affective disorder with significant socio-economic cost. Distinctive autobiographical memory impairments in depression include overgeneralization, negative-bias, and repetitive negative thinking. Some psychotherapeutic interventions are designed to address these impairments, with insufficient technological support. This paper reports on an analysis of four memory-based interventions proven effective in therapeutic practice for depression, while explores the memory impairments addressed by these interventions. We address these findings into three design implications for digital tools in this space. We suggest supports for enriched positive memory recall, strategically negative memory reappraisal and future episodic imagination

Cue self-relevance affects autobiographical memory specificity in individuals with a history of major depression.

Previously depressed and never-depressed individuals identified personal characteristics (self-guides) defining their ideal, ought, and feared selves. One week later they completed the autobiographical memory test (AMT). For each participant the number of AMT cues that reflected self-guide content was determined to produce an index of AMT cue self-relevance. Individuals who had never been depressed showed no significant relationship between cue self-relevance and specificity. In contrast, in previously depressed participants there was a highly significant negative correlation between cue self-relevance and specificity--the greater the number of AMT cues that reflected self-guide content, the fewer specific memories participants recalled. It is suggested that in individuals with a history of depression, cues reflecting self-guide content are more likely to prompt a shift to processing of information within the long-term self (Conway, Singer, and Tagini, 2004), increasing the likelihood that self-related semantic information will be provided in response to cues on the autobiographical memory test