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Depressive Disorder, MajorNCT02938559

Can the Memory Support Intervention Improve Depression Outcome Following Cognitive Therapy?

A study testing Cognitive Therapy (CT) for depression and Cognitive Therapy (CT) for depression + Memory Support in people with Depressive Disorder, Major, run by University of California, Berkeley at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this study protocol is to conduct a confirmatory efficacy trial to test whether the Memory Support Intervention improves illness course and functional outcomes in major depressive disorder (MDD) and cognitive therapy (CT). Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Depressive Disorder, Major
What is being tested?
Cognitive Therapy (CT) for depression and Cognitive Therapy (CT) for depression + Memory Support
Could I receive a placebo?
No, everyone receives an active treatment
How many people
178 participants
Where
1 siteUnited States
Study dates
Nov 2016to 5 Aug 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age 18+ years
  • Willing and able to give full consent
  • English language fluency
  • Diagnosis of major depressive disorder (MDD), first episode, recurrent or chronic, according to DSM-5
  • Minimum score 26 or above on the Inventory of Depressive Symptomatology, Self-Report (IDS-SR). This cutoff denotes at least 'moderate' depression
  • If taking medications for mood, medications must be stable for the past four weeks

Who cannot join

  • History of Bipolar Disorder
  • History of Psychosis or psychotic features
  • Lifetime history of failure to respond to 4 or more sessions of CBT/CT for depression
  • Current non-psychotic disorder if it constitutes the principal diagnosis and if it requires treatment other than that offered in the project. 'Principal' is defined as the disorder currently most distressing and disabling, using a widely accepted severity rating scale capturing distress and interference (0-8, 4+ indicates clinical severity)
  • Moderate or severe substance use in the past 6 months where 'moderate' is defined as 4-5 symptoms and 'severe' is defined as 6+ listed in DSM-5 for each of the substance-related disorders
  • Evidence of any medical disorder or condition that could cause depression, preclude participation in CT, or is associated with memory problems, that is not currently stabilized and/or managed under the care of a physician or the presence of an active and progressive physical illness or neurological degenerative disease,
Show all 9Show fewer
  • Current suicide risk sufficient to preclude treatment on an outpatient basis (assessed by the Columbia-Suicide Severity Rating Scale) or current homicide risk (assessed by our staff, a case manager or psychiatrist)
  • Pregnancy or breastfeeding
  • Not able/willing to participate in and/or complete the pre-treatment assessments

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of California, Berkeley

    Berkeley, California, 94720-1650

Other trials in United States

About this study

The aim of this study protocol is to conduct a confirmatory efficacy trial to test whether the Memory Support Intervention improves illness course and functional outcomes in major depressive disorder (MDD) and cognitive therapy (CT).

Read the detailed description

Background. Major depressive disorder (MDD) is one of the most prevalent psychiatric disorders and a leading cause of disability worldwide. Existing therapies fail to produce complete recovery. Progress toward improving outcome must include innovations that are safe, powerful, inexpensive and simple (for fast and effective dissemination). The proposed research seeks to test one such innovation. The investigators seek to improve outcome by improving memory for the content of cognitive therapy (CT) sessions. CT is one of the most promising approaches to the treatment of MDD, yet there is room for improvement.

It is proposed that adding memory enhancing strategies to CT may improve MDD outcome because: (a) MDD is often characterized by memory impairment, (b) there is evidence that the memory impairment is modifiable, (c) CT typically entails the activation of emotion, (d) emotion can impair or bias memory and (e) there is evidence that memory for the content of therapy sessions is poor.

Hence, the overall goal is to evaluate if integrating strategies designed to enhance memory for the content of CT sessions improves treatment outcome for MDD. Cognitive support involves a series of specific procedures that support the encoding and retrieval stages of an episodic memory. It is hypothesized that CT+Memory Support, relative to CT-as-usual, will be associated with improved illness course and functional outcome at the end of treatment as well as 6 and 12 months post-treatment.

Being tested
Cognitive Therapy (CT) for depression, Cognitive Therapy (CT) for depression + Memory Support
Medical subject headings
Depressive Disorder, Major

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cognitive Therapy (CT) for depressionBehavioural

    There is evidence that CT for major depressive disorder (MDD) can be as effective as antidepressant medication for the initial treatment of moderate to severe MDD. Moreover, following the withdrawal of treatment, patients treated with CT are significantly less likely to relapse than patients treated with antidepressant medication and CT is at least as effective as antidepressant medication in preventing subsequent relapse. CT aims to alter the symptomatic expression of depression and reduce risk for subsequent episodes by correcting the negative beliefs and maladaptive information processing presumed to underlie the disorder and alter the systematic tendency to misperceive reality in a pessimistic fashion.

  • Cognitive Therapy (CT) for depression + Memory SupportBehavioural

    The Memory Support Intervention will be delivered interwoven with CT. The Memory Support Intervention is designed to improve patient memory for treatment and involves a series of specific procedures that support the encoding and retrieval stages of episodic memory. It is comprised of eight memory promoting strategies: attention recruitment, categorization, evaluation, application, repetition, practice remembering, cued-based reminder and praise recall. These strategies are proactively, strategically and intensively integrated into treatment-as-usual to support encoding. Memory support is delivered alongside each 'treatment point', defined as a main idea, principle, or experience that the treatment provider wants the patient to remember or implement as part of the treatment.

Study groups in NCT02938559
Study groupRoleWhat they receive
Cognitive Therapy plus Memory SupportExperimentalNot described
Receives: Behavioral: Cognitive Therapy (CT) for depression + Memory Support
Cognitive Therapy-as-usualActive comparatorNot described
Receives: Behavioral: Cognitive Therapy (CT) for depression

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Remission

    % Remission is defined as signs and symptoms must be absent or close to it for >=3 weeks and operationalized as IDS-SR less than 14.

    Measured: Post-Treatment which is two weeks after final therapy session (i.e. 18-20 weeks after initial intake interview)

  2. Relapse at 6 Months

    % Relapse is defined as 'return to an MDE following remission' and operationalized as greater than or equal to 14 on the IDS-SR at follow-up for those who had remitted.

    Measured: Calculated at 6-months after the end of treatment [the end of treatment is defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview

  3. Relapse at 12 Months

    % Relapse is defined as 'return to an MDE following remission' and operationalized as greater than or equal to 14 on the IDS-SR at follow-up for those who had remitted.

    Measured: Calculated at 12 months after the end of treatment [the end of treatment is defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview

  4. Functional Impairment

    WHODAS 2.0 total score

    Measured: Change from pre-treatment to post-treatment defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  5. Patient Memory for Treatment

    Cumulative Recall on the Patient Treatment Recall Task

    Measured: Week 4, Week 8, Week 12, Week 16 of treatment as well as Post Treatment, defined as two post-treatment defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  6. Generalization Task

    Measured: Week 4, Week 8, Week 12, and Week 16 of treatment as well as Post Treatment, defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  7. Declarative Memory

    Hit Rate minus False Alarm Rate minus Lure Rate on the Episodic Face-Name Learning Task

    Measured: Change from pre-treatment to post-treatment defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  8. Working Memory

    No. of correct hits minus the no. of false positives on 3-Back of the N-Back

    Measured: Change from pre-treatment to post-treatment defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  9. Memory Support

    Total Amount on the Memory Support Rating Scale on randomly selected therapy tapes.

    Measured: 20-26 sessions of treatment (over 16 weeks) spanning 18-20 weeks after initial intake interview

Secondary outcomes (10)
  1. Response to Treatment

    % Response is defined as a clinically significant degree of symptom reduction and operationalized as 50% reduction in pre-treatment symptom severity on the IDS-SR.

    Measured: Post-Treatment which is two weeks after final therapy session (i.e. 18-20 weeks after initial intake interview)

  2. Magnitude of symptom change is operationalized as change on IDS-SR

    Measured: Change from Pretreatment to Post-Treatment

  3. Recovery

    % Recovery is defined as 'remission sustained for >=4 months' and is operationalized via the LIFE.

    Measured: Calculated at 6-months and 12-months after the end of treatment [the end of treatment is defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview

  4. Recurrence

    % Recurrence is defined as 'return to an MDE following recovery' and is established using the SCID.

    Measured: Calculated at 6-months and 12-months after the end of treatment [the end of treatment is defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview

  5. Time to relapse or recurrence

    Time to relapse or recurrence following response or remission will be established using the SCID.

    Measured: Calculated at 6-months and 12-months after the end of treatment [the end of treatment is defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview

  6. Functional Impairment

    4-question Healthy Days core module

    Measured: Change from pre-treatment to post-treatment defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  7. Patient Memory for Treatment

    Past Session Recall on the Patient Treatment Recall Task

    Measured: Change from pre-treatment to post-treatment defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  8. Working Memory

    No. of correct hits minus the no. of false positives on 0-Back, 1-Back, 2-Back of the N-Back

    Measured: Change from pre-treatment to post-treatment defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview) to 6-month follow-up to 12-month follow-up

  9. Memory Support

    Number of Types on the Memory Support Rating Scale

    Measured: 20-26 sessions of treatment (over 16 weeks) spanning 18-20 weeks after initial intake interview

  10. Competencies of Cognitive Therapy Scale (CCTS) (Exploratory)

    Measure of patient competence at using cognitive therapy skills.

    Measured: Post Treatment, defined as two weeks after the final therapy session (i.e. 18-20 weeks after the initial intake interview), 6 month Follow-Up, 12 month Follow-Up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Oct 2016 (estimated)
  2. Study startNov 2016
  3. Primary completion5 Aug 2020
  4. Study completion5 Aug 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
178 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02938559
Sponsor's protocol ID
R01MH108657
Status last verified
Jan 2021
First submitted
6 Oct 2016
Last updated
2 Feb 2021
Results posted
No
Data monitoring committee
Yes

Publications

  • Callaway CA, Milner AE, Zieve GG, Ashlock L, Harvey AG. Therapist memory for treatment contents: Implications for patient outcomes. Behav Res Ther. 2026 Jun;201:105037. doi: 10.1016/j.brat.2026.105037. Epub 2026 Apr 6.

    PubMed 41955881
  • Sarfan LD, Zieve G, Gumport NB, Xiong M, Harvey AG. Optimizing outcomes, mechanisms, and recall of Cognitive Therapy for depression: Dose of constructive memory support strategies. Behav Res Ther. 2023 Jul;166:104325. doi: 10.1016/j.brat.2023.104325. Epub 2023 May 13.

    PubMed 37210887
  • Gumport NB, Zieve GG, Dong L, Harvey AG. The Development and Validation of the Memory Support Treatment Provider Checklist. Behav Ther. 2021 Jul;52(4):932-944. doi: 10.1016/j.beth.2020.11.005. Epub 2020 Dec 17.

    PubMed 34134832

Questions about this trial

What is this clinical trial studying?

A study testing Cognitive Therapy (CT) for depression and Cognitive Therapy (CT) for depression + Memory Support in people with Depressive Disorder, Major, run by University of California, Berkeley at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Remission (time frame: Post-Treatment which is two weeks after final therapy session (i.e. 18-20 weeks after initial intake interview)). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02938559, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Feb 2021.

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