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Trial registered on ANZCTR
Registration number
ACTRN12611000804987
Ethics application status
Approved
Date submitted
5/07/2011
Date registered
1/08/2011
Date last updated
15/12/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
The COMET study: Metacognitive Therapy and Cognitive Behaviour Therapy for Depression
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Scientific title
Will Metacognitive Therapy be more effective and act more quickly than Cognitive Behaviour Therapy in reducing depressive symptoms in outpatients with depression?
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Secondary ID [1]
262568
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Nil
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Universal Trial Number (UTN)
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Trial acronym
The COMET study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Major depressive disorder
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Condition category
Condition code
Mental Health
237177
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be randomised to receive 12 weeks of individual therapy;either Metacognitive therapy(MCT) or cognitive behaviour therapy (CBT). Most participants will receive 12 sessions in 12 weeks with 6 sessions in the first 4 weeks however the range permissible is 8 to 15 sessions over the 12 weeks. Therapy sessions last up to 1 hr. Clinical psychologists deliver both therapies and follow the work of AT Beck and J Beck for CBT(1,2) and of Adrian Wells and Costas Papageorgiou for MCT (3,4).
References
1. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. Guildford Press, New York,1979.
2. Beck JS. Cognitive therapy: basics and beyond. The Guilford Press, New York, 1995.
3. Wells A. Metacognitive Therapy for Anxiety and Depression The Guilford Press; 2009.
4. Papageorgiou C, Wells A, eds. Depressive rumination: nature, theory and treatment. John Wiley, West Sussex, England, 2004.
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Intervention code [1]
4613
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Treatment: Other
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Intervention code [2]
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Behaviour
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Comparator / control treatment
Cognitive behaviour therapy
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Control group
Active
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Outcomes
Primary outcome [1]
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Reduction in depressive symptoms at end treatment measured by change in the Quick Inventory of Depressive Symptomatology (QIDS-C-16 item) (rated by an independent rater)
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Assessment method [1]
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Timepoint [1]
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weeks 0 and 12
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Primary outcome [2]
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Speed of early change measured by reduction in Quick Inventory of Depressive Symptomatology scores (QIDS-C-16 item) (rated by an independent rater)
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Assessment method [2]
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Timepoint [2]
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weeks 0 and 4
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Primary outcome [3]
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Early change measured by percent change in brain activation on fMRI in the dorso-lateral prefrontal cortex and amygdala regions
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Assessment method [3]
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Timepoint [3]
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weeks 0 and 4
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Secondary outcome [1]
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Time to achieve non-depressed status over the course of treatment measured by the Quick Inventory of Depressive Symptomatology- self report (QIDS- SR) (survival curve, QIDS-SR<6).
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Assessment method [1]
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Timepoint [1]
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weekly self-report questionnaires for 12 weeks
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Secondary outcome [2]
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Improvement in executive functioning, measured by the Rapid Visual Information Processing (CANTAB)
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Assessment method [2]
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Timepoint [2]
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weeks 0, 4 and 12 weeks
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Secondary outcome [3]
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Improved emotional processing, measured by the Recognition of posed facial expressions task
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Assessment method [3]
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Timepoint [3]
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weeks 0, 4,and 12
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Secondary outcome [4]
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Reduction in depressive rumination, measured by the Response Styles Questionnaire- rumination subscale
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Assessment method [4]
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Timepoint [4]
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weeks 0, 4 and 12
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Secondary outcome [5]
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Reduction in maladaptive metacognitions measured by the Metacognitions-30 scale
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Assessment method [5]
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Timepoint [5]
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weeks 0, 4,and 12
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Secondary outcome [6]
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Reduction in self-report depressive symptoms at end treatment rated by the Quick Inventory of Depressive Symptomatology- self report (QIDS- SR)
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Assessment method [6]
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Timepoint [6]
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weeks 0, 4 and 12
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Eligibility
Key inclusion criteria
Current major depressive disorder (DSM-IV)
Able to complete questionnaires and psychotherapy in the english language.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
On no psychoactive drugs (e.g. antidepressants, mood stabilisers, anxiolytics or antipsychotic drugs), moderate or severe alcohol or drug dependence as a primary diagnosis, bipolar I disorder or schizophrenia, major physical illness or head injury which could interfere with the fMRI procedure, neuropsychological assessment or psychotherapy.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is concealed. The holder of the therapy allocation is outside the research team and holds the allocation in numbered sealed opaque envelopes, only releasing the envelope once the baseline assessments have been completed. Thus therapists recruiting and assessing participants are not given therapy allocation until the baseline assessment are complete, immediately prior to commencing therapy. The study co-ordinator will remain blind to therapy allocation throughout the study.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised permuted block randomisation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data analysis is complete
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Reason for early stopping/withdrawal
Other reasons/comments
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Other reasons
The pilot study was stopped due to funding ending and difficulty continuing the trial due to the disruption during 2011 caused by the Christchurch earthquakes.
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Date of first participant enrolment
Anticipated
1/06/2009
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Actual
1/09/2009
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Date of last participant enrolment
Anticipated
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Actual
14/01/2011
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Date of last data collection
Anticipated
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Actual
23/07/2013
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Sample size
Target
140
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Accrual to date
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Final
48
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Canterbury
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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New Zealand Lottery Health Research grant
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Address [1]
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Lottery Health Research
Department of Internal Affairs
46 Waring Taylor St
PO Box 805
WELLINGTON 6011
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Country [1]
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New Zealand
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Funding source category [2]
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University
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Name [2]
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University of Otago Research Committee Grant
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Address [2]
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Research & Enterprise Office
Centre for Innovation
University of Otago
Po Box 56 Cnr St David and Castle St
Dunedin, 9054
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Country [2]
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New Zealand
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Primary sponsor type
Individual
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Name
Jennifer Jordan
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Address
Department of Psychological Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country
New Zealand
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Secondary sponsor category [1]
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University
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Name [1]
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Research Office, University of Otago, Christchurch
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Address [1]
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University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country [1]
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New Zealand
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Other collaborator category [1]
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Individual
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Name [1]
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Professor Peter Joyce
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Address [1]
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Department of Psychological Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country [1]
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New Zealand
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Other collaborator category [2]
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Individual
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Name [2]
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Dr Janet D Carter
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Address [2]
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Psychology Department
University of Canterbury
Private Bag 4800
University Drive, Ilam
Christchurch 8041
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Country [2]
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New Zealand
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Other collaborator category [3]
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Individual
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Name [3]
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Dr Virginia VW McIntosh
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Address [3]
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Department of Psychological Medicine (& Canterbury District Health Board)
University of Otago, Christchurch
4 Oxford Terrace
Po Box 4345
Christchurch 8140
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Country [3]
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New Zealand
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Other collaborator category [4]
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Individual
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Name [4]
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Professor Richard Porter
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Address [4]
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Department of Psychological Medicine
University of Otago, Christchurch
4 Oxford Terrace
Po Box 4345
Christchurch 8140
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Country [4]
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New Zealand
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Other collaborator category [5]
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Individual
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Name [5]
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Professor Roger Mulder
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Address [5]
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Department of Psychological Medicine
University of Otago, Christchurch
4 Oxford Terrace
Po Box 4345
Christchurch 8140
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Country [5]
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New Zealand
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Other collaborator category [6]
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Individual
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Name [6]
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Dr Kumari Fernando
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Address [6]
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Department of Psychological Medicine
Dunedin School of Medicine
PO Box 913
University of Otago
Dunedin 9054
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Country [6]
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New Zealand
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Other collaborator category [7]
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Individual
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Name [7]
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Associate Professor Christopher Frampton
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Address [7]
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Department of Psychological Medicine
University of Otago, Christchurch
4 Oxford Terrace
Po Box 4345
Christchurch 8140
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Country [7]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Upper South B Regional Ethics Committee
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Ethics committee address [1]
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Ministry of Health PO Box 3877 Christchurch 8013
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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11/05/2009
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Ethics approval number [1]
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URB/09/03/012
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Summary
Brief summary
Depression is a common, often recurrent or chronic, serious health problem causing significant burden to individuals, their families and to society. The most evaluated psychotherapy, Cognitive Behaviour Therapy (CBT) is effective for around 50% of depressed individuals but relapse is common. Despite advances in knowledge about brain dysfunction and changes with recovery from depression, until recently there has been little integration of those findings with developments in the psychotherapy literature. Metacognitive Therapy (MCT) is a brief, innovative, targeted psychotherapy partly based on evidence of dysfunction in cognitive and emotional processing. We propose to treat 140 outpatients with depression in a randomised controlled trial of MCT vs. CBT. We hypothesise that MCT will act more rapidly and effectively in improving depression, with changes detectable on fMRI in a subset of participants. Being better able to understand how psychotherapies work in relation to brain function will contribute to development of better treatments.
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Trial website
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Trial related presentations / publications
Jordan J, Carter JD, McIntosh VV, Fernando K, Frampton CM, Porter RJ, et al. Metacognitive therapy versus cognitive behaviour therapy for depression: A randomised pilot study. Australian and New Zealand Journal of Psychiatry. 2014; 48(10):932–943. Groves S, Porter R, Jordan J, Knight R, Carter J, McIntosh V, Fernando K, Frampton CM, Mulder RT, Lacey, Joyce PR. Changes in neuropsychological function after treatment with metacognitive therapy or cognitive behaviour therapy for depression. Depression and Anxiety. 2015; 36(6):437-44.
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Public notes
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Contacts
Principal investigator
Name
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Dr Jennifer Jordan
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Address
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Department of Psychological Medicine University of Otago, Christchurch PO Box 4345 Christchurch 8140
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Country
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New Zealand
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Phone
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+64 3 3726700
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Jennifer Jordan
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Address
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Department of Psychological Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country
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New Zealand
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Phone
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+64 3 3726700
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Jennifer Jordan
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Address
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Department of Psychological Medicine
University of Otago, Christchurch
PO Box 4345
Christchurch 8140
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Country
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New Zealand
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Phone
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+64 3 3726700
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Long-term efficacy of metacognitive therapy and cognitive behaviour therapy for depression.
2022
https://dx.doi.org/10.1177/00048674211025686
N.B. These documents automatically identified may not have been verified by the study sponsor.
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