Background: While existing psychological treatments for depression are effective for many, a
significant proportion of depressed individuals do not respond to current approaches and few
remain well over the long-term. Anhedonia (a loss of interest or pleasure) is a core symptom
of depression which predicts a poor prognosis but has ...
Background: While existing psychological treatments for depression are effective for many, a
significant proportion of depressed individuals do not respond to current approaches and few
remain well over the long-term. Anhedonia (a loss of interest or pleasure) is a core symptom
of depression which predicts a poor prognosis but has been neglected by existing treatments.
Augmented Depression Therapy (ADepT) has been co-designed with service-users to better
target anhedonia alongside other features of depression. This mixed methods pilot trial aims
to establish proof of concept for ADepT and to examine the feasibility and acceptability of a
future definitive trial evaluating the clinical and cost-effectiveness of ADepT, compared to an
evidence-based mainstream therapy (Cognitive Behavioural Therapy; CBT) in the acute
treatment of depression, the prevention of subsequent depressive relapse, and the
enhancement of wellbeing.
Methods: We aim to recruit 80 depressed participants and randomize them 1:1 to receive
ADepT (15 weekly acute and 5 booster sessions in following year) or CBT (20 weekly acute
sessions). Clinical and health economic assessments will take place at intake and at six-,
twelve- and eighteen-month follow up. Reductions in PHQ-9 depression severity and
increases in WEMWBS wellbeing at six-month assessment (when acute treatment should be
completed) are the co-primary outcomes. Quantitative and qualitative process evaluation will
assess mechanism of action, implementation issues, and contextual moderating factors. To
evaluate proof of concept, intake-post effect sizes and the proportion of individuals showing
reliable and clinically significant change on outcome measures in each arm at each follow up
will be reported. To evaluate feasibility and acceptability, we will examine recruitment,
retention, treatment completion and data completeness rates and feedback from patients and
therapists about their experience of study participation and therapy. Additionally, we will
establish the cost of delivery of ADepT.
ADepT protocol paper: target journal Trials
Discussion: We will proceed to definitive trial if any concerns about the safety, acceptability,
feasibility, and proof of concept of ADepT and trial procedures can be rectified and we
recruit, retain and collect follow up data on at least 60% of the target sample.