Statistical analysis plan for a parallel group randomized clinical trial comparing schema therapy versus treatment as usual for outpatients with difficult-to-treat depression (DEPRE-ST).

IF 2 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Trials Pub Date : 2025-09-01 DOI:10.1186/s13063-025-09012-4
Ida-Marie T P Arendt, Matthias Gondan, Sophie Juul, Lene Halling Hastrup, Carsten Hjorthøj, Stine B Moeller
{"title":"Statistical analysis plan for a parallel group randomized clinical trial comparing schema therapy versus treatment as usual for outpatients with difficult-to-treat depression (DEPRE-ST).","authors":"Ida-Marie T P Arendt, Matthias Gondan, Sophie Juul, Lene Halling Hastrup, Carsten Hjorthøj, Stine B Moeller","doi":"10.1186/s13063-025-09012-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>\"Difficult-to-treat\" depression - here operationalized as either chronic or treatment-resistant depression - encompasses about one third of all patients with depression. Despite its considerable size, the patient group is understudied, and evidence-based psychotherapeutic treatment options are currently limited. The DEPRE-ST trial therefore seeks to investigate beneficial and harmful effects of schema therapy for difficult-to-treat depression.</p><p><strong>Methods: </strong>This is a randomized multicenter parallel-group superiority clinical trial. A total of 129 patients will be randomized to receive either 30 sessions of individual schema therapy or psychotherapy according to Treatment As Usual, along with psychopharmacological treatment. Participants are assessed before randomization and at 6, 12, and 24 months after randomization. The primary outcome is depression symptoms (6-item Hamilton Rating Scale for Depression), assessed at 12 months. Secondary outcomes include health-related quality of life (European Quality of Life 5 Dimensions 5 Level Version), functional impairment (Work and Social Adjustment Scale), psychological wellbeing (WHO-5 Well-being Index), and negative effects of treatment (Negative Effects Questionnaire), alongside a range of patient-relevant exploratory outcomes. Blinding of treatment allocation is ensured for primary outcome assessors, statisticians, and the data safety and monitoring committee. The primary outcome will be analyzed with multilevel linear regression, with conservative multiple imputation for missing data, and presented as the covariate-adjusted difference between treatments' change scores with its 95% confidence intervals. Further, a health economic analysis will be performed.</p><p><strong>Discussion: </strong>This statistical analysis plan was developed and submitted before unblinding of data to ensure transparency and diminish bias in selection, analysis, and reporting of results.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05833087. Registered on 15th April 2023. https://clinicaltrials.gov/study/NCT05833087?term=depre-st&checkSpell=false&rank=1.</p>","PeriodicalId":23333,"journal":{"name":"Trials","volume":"26 1","pages":"334"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403386/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Trials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13063-025-09012-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: "Difficult-to-treat" depression - here operationalized as either chronic or treatment-resistant depression - encompasses about one third of all patients with depression. Despite its considerable size, the patient group is understudied, and evidence-based psychotherapeutic treatment options are currently limited. The DEPRE-ST trial therefore seeks to investigate beneficial and harmful effects of schema therapy for difficult-to-treat depression.

Methods: This is a randomized multicenter parallel-group superiority clinical trial. A total of 129 patients will be randomized to receive either 30 sessions of individual schema therapy or psychotherapy according to Treatment As Usual, along with psychopharmacological treatment. Participants are assessed before randomization and at 6, 12, and 24 months after randomization. The primary outcome is depression symptoms (6-item Hamilton Rating Scale for Depression), assessed at 12 months. Secondary outcomes include health-related quality of life (European Quality of Life 5 Dimensions 5 Level Version), functional impairment (Work and Social Adjustment Scale), psychological wellbeing (WHO-5 Well-being Index), and negative effects of treatment (Negative Effects Questionnaire), alongside a range of patient-relevant exploratory outcomes. Blinding of treatment allocation is ensured for primary outcome assessors, statisticians, and the data safety and monitoring committee. The primary outcome will be analyzed with multilevel linear regression, with conservative multiple imputation for missing data, and presented as the covariate-adjusted difference between treatments' change scores with its 95% confidence intervals. Further, a health economic analysis will be performed.

Discussion: This statistical analysis plan was developed and submitted before unblinding of data to ensure transparency and diminish bias in selection, analysis, and reporting of results.

Trial registration: ClinicalTrials.gov NCT05833087. Registered on 15th April 2023. https://clinicaltrials.gov/study/NCT05833087?term=depre-st&checkSpell=false&rank=1.

Abstract Image

Abstract Image

一项平行组随机临床试验的统计分析计划,比较图式疗法与常规疗法对门诊难治性抑郁症(DEPRE-ST)的治疗效果。
背景:“难治性”抑郁症——这里被定义为慢性或难治性抑郁症——约占所有抑郁症患者的三分之一。尽管其规模相当大,但患者群体尚未得到充分研究,基于证据的心理治疗治疗方案目前有限。因此,DEPRE-ST试验旨在调查图式疗法对难以治疗的抑郁症的有益和有害影响。方法:这是一项随机多中心平行组优势临床试验。129名患者将随机接受30次个体图式治疗或根据常规治疗进行心理治疗,并进行心理药物治疗。在随机化前和随机化后6、12和24个月对参与者进行评估。主要结果是抑郁症状(6项汉密尔顿抑郁量表),在12个月时进行评估。次要结局包括与健康相关的生活质量(欧洲生活质量5维度5水平版本)、功能障碍(工作和社会适应量表)、心理健康(世卫组织5幸福指数)和治疗的负面影响(负面影响问卷),以及一系列与患者相关的探索性结果。确保对主要结果评估者、统计学家和数据安全和监测委员会的治疗分配进行盲法。主要结局将采用多水平线性回归进行分析,对缺失数据进行保守多元拟合,并以协变量调整后的治疗变化评分差异及其95%置信区间表示。此外,还将进行卫生经济分析。讨论:本统计分析计划是在数据解盲之前制定并提交的,以确保透明度,减少选择、分析和报告结果的偏差。试验注册:ClinicalTrials.gov NCT05833087。于2023年4月15日注册。https://clinicaltrials.gov/study/NCT05833087?term=depre-st&checkSpell=false&rank=1。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Trials
Trials 医学-医学:研究与实验
CiteScore
3.80
自引率
4.00%
发文量
966
审稿时长
6 months
期刊介绍: Trials is an open access, peer-reviewed, online journal that will encompass all aspects of the performance and findings of randomized controlled trials. Trials will experiment with, and then refine, innovative approaches to improving communication about trials. We are keen to move beyond publishing traditional trial results articles (although these will be included). We believe this represents an exciting opportunity to advance the science and reporting of trials. Prior to 2006, Trials was published as Current Controlled Trials in Cardiovascular Medicine (CCTCVM). All published CCTCVM articles are available via the Trials website and citations to CCTCVM article URLs will continue to be supported.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信