Improving Mood in Veterans in Primary Care



Status:Completed
Conditions:Depression, Depression
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - Any
Updated:11/2/2018
Start Date:March 23, 2015
End Date:July 31, 2018

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RCT of Behavioral Activation for Depression and Suicidality in Primary Care

The purpose of the Improving Mood in Veterans in Primary Care (IIR 14-047) is to evaluate a
brief educational individual workshop that is meant to help Veterans better understand
feelings of sadness and ways to improve their mood. This study is intended to evaluate and
establish the workshop's effectiveness for use with Veterans in primary care settings.

The study involves up to 6 in-person meetings and 6 telephone interviews across a 6-month
period of time. Approximately 144 Veterans will participate in the study. Using a procedure
like the flip of a coin, the participants will have a one in two chance of receiving the
brief educational workshop or treatment as usual condition.

Background:

Depressive symptoms are the most common referral problem to integrated mental health
providers within Veteran primary care clinics. Although there exist several empirically-based
brief psychotherapies for depression in primary care, the most significant barrier to
providing those psychotherapies is treatment duration (e.g., the treatments range from 6-8
sessions of 30-50 minutes) as it does not match typical treatment formats delivered by mental
health providers working in primary care (i.e., 1-4 15-30 minute sessions). Therefore, this
HSR&D study titled, RCT of Behavioral Activation for Depression and Suicidality in Primary
Care, will examine the effectiveness of a brief version of an existing efficacious longer
treatment for depression, called behavioral activation.

Objectives:

The overarching objectives of this study are to: 1) examine whether a 4-session manualized
behavioral activation intervention (BA-PC) compared to Treatment as Usual (TAU) is effective
in reducing self-reported depressive symptoms and subjective secondary outcomes such as sleep
impairment and quality of life; 2) examine patient satisfaction, engagement, and receptivity
to a 4-session BA-PC; and 3) explore the impact of BA-PC on suicidal ideation.

Methods:

The study will achieve these objectives using a randomized, controlled trial study design
that has two conditions (4-session BA-PC and Treatment as Usual). Veterans will be recruited
from three VA primary care settings in the Western portion of VISN 2 (Syracuse, Rochester,
and Buffalo). The primary inclusion criteria for the study will be a report of depressive
symptoms by primary care patients, who are not currently engaged in psychological treatment
for depression. A total of 136 Veterans will be targeted for randomization. All Veterans will
be assessed every 2 weeks for changes in mood and more comprehensive assessments will be
completed at 6, 12, and 24 weeks.

Status:

Recruitment has ended as of 2/26/18 with 140 participants being randomized. Follow-up will
continue for another 24 weeks. We are preparing the data for analysis.

Inclusion Criteria:

Veterans:

- aged 18 years

- seeking or receiving primary care services at the Syracuse, Canandaigua, or Buffalo VA
Medical Centers

- reporting at least moderate depressive symptoms

- stable course of antidepression medications

- stable course of outpatient treatment for anxiety or substance use disorders

Exclusion Criteria:

Veterans who are:

- unable to demonstrate an understanding of the informed consent

- non-English speaking

- reporting imminent risk of suicide

- have an unstable psychiatric condition

- currently involved in treatment for depression

- recently started antidepression medication or outpatient treatment for anxiety or
substance use disorder

- currently involved or completed inpatient or intensive outpatient treatment
We found this trial at
3
sites
Canandaigua, New York 14424
Phone: 585-393-7918
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Canandaigua, NY
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Buffalo, New York 14215
Phone: 716-862-8598
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Buffalo, NY
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Syracuse, New York 13210
Principal Investigator: Jennifer Schum Funderburk, PhD
Phone: (315) 425-4400
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Syracuse, NY
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