2 MULTICENTER STUDIES OF BEHAVIOR-THERAPY AND PHARMACOTHERAPY FOR UNIPOLAR DEPRESSION - STARTING POINT, RESEARCH QUESTIONS, PROCEDURE, METHODS, AND INTERVENTIONS

Following a short review of treatment outcome studies with unipolar de pressed patients, research questions and rationals were presented for two large scale, multi-center, prospective, controlled treatment compa rison studies of in- and outpatients with either endogenous or non-end ogenous unipolar depression. We also present both designs, interventio ns, methods, samples, and setting of treatments. Both studies investig ated the effectiveness of a pharmacotherpy (plus clinical management) as a standard intervention with severely depressed patients, cognitive behavior therapy as a psychological approach, and the combination of pharmacotherapy and behavior therapy. All interventions were delivered in four psychiatric clinics with inpatients and with outpatients in a mbulatory settings. Treatment effects were assessed according to a mul ti-methodological approach, measuring depression, anxiety, sleep, body complaints, cognitions, motor behavior, social functioning, several o ther aspects of psychopathology, self-control, and personality variabl es. We were interested in the short-term effects and in the outcome af ter one-year follow-up. Beside the outcome related research questions, we also studied process variables during treatment and during follow- up. With these investigations we tried to replicate several aspects of earlier studies as well as to control some new relevant variables, e. g. setting, diagnostic subgroups. We had the ambition to make a signif icant contribution to treatment research and results should have impac t on mental health services in our country.