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Randomized Controlled Trial
. 2015 Jul 17;5(7):e008857.
doi: 10.1136/bmjopen-2015-008857.

Refractory depression: mechanisms and evaluation of radically open dialectical behaviour therapy (RO-DBT) [REFRAMED]: protocol for randomised trial

Affiliations
Randomized Controlled Trial

Refractory depression: mechanisms and evaluation of radically open dialectical behaviour therapy (RO-DBT) [REFRAMED]: protocol for randomised trial

T R Lynch et al. BMJ Open. .

Abstract

Introduction: Only 30-40% of depressed patients treated with medication achieve full remission. Studies that change medication or augment it by psychotherapy achieve only limited benefits, in part because current treatments are not designed for chronic and complex patients. Previous trials have excluded high-risk patients and those with comorbid personality disorder. Radically Open Dialectical Behaviour Therapy (RO-DBT) is a novel, transdiagnostic treatment for disorders of emotional over-control. The REFRAMED trial aims to evaluate the effectiveness and cost-effectiveness of RO-DBT for patients with treatment-resistant depression.

Methods and analysis: REFRAMED is a multicentre randomised controlled trial, comparing 7 months of individual and group RO-DBT treatment with treatment as usual (TAU). Our primary outcome measure is depressive symptoms 12 months after randomisation. We shall estimate the cost-effectiveness of RO-DBT by cost per quality-adjusted life year. Causal analyses will explore the mechanisms by which RO-DBT is effective.

Ethics and dissemination: The National Research Ethics Service (NRES) Committee South Central - Southampton A first granted ethical approval on 20 June 2011, reference number 11/SC/0146.

Trial registration number: ISRCTN85784627.

Keywords: Radically Open Dialectical Behaviour Therapy; Refractory Depression; Study Protocol.

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Figures

Figure 1
Figure 1
CONSORT diagram of REFRAMED study participant recruitment, assessment and follow-up timeline.

References

    1. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 1997;349:1498–504. 10.1016/S0140-6736(96)07492-2 - DOI - PubMed
    1. Layard R, Clark D, Knapp M et al. . Implementing the NICE guidelines for depression and anxiety. A cost-benefit analysis. London School of Economics website, 2006.
    1. Berlim MT, Turecki G. What is the meaning of treatment resistant/refractory major depression (TRD)? A systematic review of current randomized trials. Eur Neuropsychopharmacol 2007;17:696–707. 10.1016/j.euroneuro.2007.03.009 - DOI - PubMed
    1. Fournier JC, DeRubeis RJ, Shelton RC et al. . Prediction of response to medication and cognitive therapy in the treatment of moderate to severe depression. J Consult Clin Psychol 2009;77:775–87. 10.1037/a0015401 - DOI - PMC - PubMed
    1. McPherson S, Cairns P, Carlyle J et al. . The effectiveness of psychological treatments for treatment-resistant depression: a systematic review. Acta Psychiatr Scand 2005;111:331–40. 10.1111/j.1600-0447.2004.00498.x - DOI - PubMed

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