Behavioral Activation - From Inpatient to Outpatient Services

Uppsala University

Status: Completed

Conditions: Depressive Symptoms; Inpatient Facility Diagnoses; Psychiatric Disorders

Treatments: Behavioral: Behavioral Activation; Behavioral: Supportive Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT01786733

Dnr 2012 / 226

Details and patient eligibility

About

The purpose of this study is to compare the effectiveness of Behavioral Activation and Supportive Therapy added to the standard acute psychiatric inpatient care. Therapy starts during inpatient care and can continue in an outpatient facility if the patients are discharged before 12 sessions has been completed.

Full description

Psychiatric inpatient care is reserved for individuals with the most acute mental health problems. The period after discharge is associated with increased risk for relapse, non-adherence and suicide. Delivering high quality psychosocial interventions during and after acute psychiatric inpatient care is known to be a difficult challenge. This study will investigate the effectiveness of adding either Behavioral Activation or Supportive Therapy to the standard acute psychiatric inpatient care. Subjects with different psychiatric diagnoses and elevated depressive symptoms are assessed and randomized after admission. Therapists from the nearest outpatient facility initiate 12 sessions of Behavioral Activation or Supportive Therapy as soon as possible. The 12 sessions are delivered twice weekly at the inpatient unit or at the outpatient facility, depending on whether the patient is admitted or discharged. Treatment as usual interventions(medications, nursing etc.) are not manipulated in the study. The main assessment points are pre-, post, 6 months follow-up and 12 months follow-up. The main outcome measure and some process measures are also administered at session 3, 6 and 9.

Enrollment: 64 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Admitted into one of four acute psychiatric inpatient units in Dalarna
• MADRS-S 20 and above at acute admission and and after 2-3 days on the ward
• Psychiatric disorder according to M.I.N.I (Sheehan et al., 1998)
• Read and Speak Swedish

Exclusion criteria

• Acute psychotic symptoms
• Acute manic symptoms
• Confusion
• Primary eating disorder
• Primary alcohol or substance abuse disorder
• Self rated score on AUDIT (Saunders et al., 1993)of 20 or greater
• Mental retardation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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64 participants in 2 patient groups

Behavioral Activation

Experimental group

Description:

Behavioral Activation + Treatment as Usual. 12 sessions twice weekly (i.e. 6 weeks). Individual therapy. Therapy is initiated during inpatient admission and continue after discharge. Protocol aimed at increased activation towards goals and personal values and decreased avoidance behaviors.

Treatment:

Behavioral: Behavioral Activation

Supportive Therapy

Active Comparator group

Description:

Supportive Therapy + Treatment as Usual. 12 sessions twice weekly (i.e. 6 weeks). Individual therapy. Therapy is initiated during inpatient admission and continue after discharge. Protocol aimed at providing psychological non-directive support.

Treatment:

Behavioral: Supportive Therapy