Schema Therapy for Chronic Depression
Schema Therapy for Chronic Depression
To compare the efficacy of schema therapy versus active monitoring for women with chronic
 depression receiving psychiatric care.
A randomized, assessor-blind, single center, superiority trial will be conducted.
 Participants will be referred to clinical psychologists in a private counseling office
 (Senzoku Stress Coping Support Office, in Japan). Eligible participants will be women with
 chronic depression receiving psychiatric care. Participants will receive schema therapy or
 active monitoring during 2 years. Primary outcome will be treatment response. A total sample
 size of 64 (32 in each group) would be required to provide 80% power at a 2-sided
 significance level of 5% to detect a risk difference of 35% (response rate: 55% for schema
 therapy vs. 20% for active monitoring), assuming a dropout rate of 10%.
Inclusion Criteria:

 -  Persistent depressive disorder including chronic major depressive disorder and
 dysthymic disorder assessed by the Structured Clinical Interview for DSM

 -  Scores of at least 14 on the GRID-HAMD

 -  Psychiatric treatment duration for depression of at least 3 years

 Exclusion Criteria:

 -  Psychiatric hospitalization within 30 days prior to the enrollment

 -  Ineligible to receive the protocol treatment during 2 years

 -  Schizophrenia

 -  Bipolar disorders

 -  Intellectual disabilities

 -  Neurocognitive disorders

 -  Substance-related disorders