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Randomized Controlled Trial
. 2023 Dec:330:115581.
doi: 10.1016/j.psychres.2023.115581. Epub 2023 Oct 30.

Effect of modernized collaborative care for depression on brain-derived neurotrophic factor (BDNF) and depressive symptom clusters: Data from the eIMPACT trial

Christopher A Crawford  1 , Michelle K Williams  1 , Aubrey L Shell  1 , Krysha L MacDonald  2 , Robert V Considine  3 , Wei Wu  1 , Kevin L Rand  1 , Jesse C Stewart  4
Affiliations
Randomized Controlled Trial

Effect of modernized collaborative care for depression on brain-derived neurotrophic factor (BDNF) and depressive symptom clusters: Data from the eIMPACT trial

Christopher A Crawford et al. Psychiatry Res. 2023 Dec.

Abstract

Brain-derived neurotrophic factor (BDNF) levels are lower in people with depression and are normalized following pharmacological treatment. However, it is unknown if psychological treatments for depression improve BDNF and if change in BDNF is a mediator of intervention effects on depressive symptoms. Therefore, using data from the eIMPACT trial, we sought to determine the effect of modernized collaborative care for depression on 12-month changes in BDNF and cognitive/affective and somatic depressive symptom clusters and to examine whether BDNF changes mediate intervention effects on depressive symptoms. 216 primary care patients with depression from a safety net healthcare system were randomized to 12 months of the eIMPACT intervention (internet cognitive-behavioral therapy [CBT], telephonic CBT, and select antidepressant medications) or usual primary care. Plasma BDNF was measured with commercially available kits, and depressive symptom clusters were assessed by the Patient Health Questionnaire-9. The intervention did not influence BDNF but did improve both the cognitive/affective and somatic clusters over 12 months. Changes in BDNF did not mediate the intervention effect on either cluster. Our findings suggest that modernized collaborative care is an effective treatment for both the cognitive/affective and somatic symptoms of depression and that the mechanism of action is not improvements in BDNF. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02458690.

Keywords: Affective symptoms; Antidepressant medication; Cognitive behavioral therapy; Internet-based intervention; Primary health care; Randomized controlled trial; Somatic symptoms.

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Conflict of interest statement

Declaration of Competing Interest The authors have no potential conflicts of interest to declare related to the subject matter of this article. JCS received grants from the NIH. J.C.S. received advisory fees from Boston Medical Center.

Figures

Figure 1.
Figure 1.
Results of Path Analytic Mediation Model Examining the Effect of Modernized Collaborative Care for Depression on BDNF and PHQ-9 Depressive Symptom Clusters Note. N = 216. Shading signifies statistical significance (p < .05). c’1 and c’2 are direct effects controlling for the mediator. BDNF = brain-derived neurotrophic factor; PHQ-9 = Patient Health Questionnaire-9; SE = standard error; CI = confidence interval.
See this image and copyright information in PMC

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