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dc.contributor.authorStewart, Jeremyen
dc.date2009-09-03 14:41:46.163
dc.date.accessioned2009-09-03T18:45:26Z
dc.date.available2009-09-03T18:45:26Z
dc.date.issued2009-09-03T18:45:26Z
dc.identifier.urihttp://hdl.handle.net/1974/5121
dc.descriptionThesis (Master, Psychology) -- Queen's University, 2009-09-03 14:41:46.163en
dc.description.abstractMajor Depressive Disorder (MDD) is a highly prevalent mental disorder that will affect 12.2% of Canadians over the course of their lifetimes, and 4.8% annually (Patten, et al., 2006). One of the most robust findings in the MDD literature is that the gold-standard treatments – Cognitive-Behavioral Therapy (CBT), Interpersonal Psychotherapy (IPT), and anti-depressant medications - are equal in their efficacy, and superior to placebo. However, it is unclear whether rates of remission for certain types of symptoms differ among treatments with theoretically different mechanisms. This study re-analyzed data from the Treatment of Depression Collaborative Research Program, which included 158 adults with MDD randomized to CBT, IPT, imipramine or placebo. We statistically derived 4 factors from the baseline Hamilton Depression Rating Scale. We hypothesized that the rate of remission of somatic factors (sleep and appetite) would be most rapid in the group receiving imipramine plus clinical management (IMI-CM), and that the rate of remission for cognitive-affective factors would be fastest in IPT and CBT. Hierarchical regression analyses predicted the sum of symptom scores corresponding to each factor using linear and quadratic time (measured in weeks). Treatment-by-time interactions were entered in a stepwise fashion. There were no significant interactions found in the appetite factor, suggesting that all therapies acted on these symptoms at similar rates. Consistent with hypotheses, IMI-CM produced more rapid remission in sleep symptoms compared to psychotherapy. Surprisingly, IMI-CM was also more rapid at relieving cognitive-affective symptoms. The results lend partial support to the idea that different treatments for MDD may target specific symptoms at different rates according to their underlying mechanisms of action. The findings present some exciting possibilities for elevating response rates through empirically-based “tailored treatments”.en
dc.format.extent924092 bytes
dc.format.mimetypeapplication/pdf
dc.language.isoengen
dc.relation.ispartofseriesCanadian thesesen
dc.rightsThis publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.en
dc.subjectdepressionen
dc.subjectsymptom specificityen
dc.subjecttreatmenten
dc.subjectCBTen
dc.subjectIPTen
dc.subjectantidepressant medicationsen
dc.titleThe Impact of Efficacious Treatments for Major Depressive Disorder on Remission Rates of Specific Symptoms: A Re-Analysis of the Treatment of Depression Collaborative Research Programen
dc.typethesisen
dc.description.degreeM.Sc.en
dc.contributor.supervisorHarkness, Kateen
dc.contributor.departmentPsychologyen
dc.degree.grantorQueen's University at Kingstonen


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