Personalized Treatments for Depressive Symptoms in Patients With Advanced Heart Failure
Depression, Heart Failure
About this trial
This is an interventional treatment trial for Depression
Eligibility Criteria
Inclusion Criteria:
- HF New York Heart Association classes: II-IV.
- Life expectancy of more than 6 months.
- PHQ-9 score ≥10.
- Diagnosis of Major Depressive Disorder, Persistent Depressive Disorder (Dysthymia), and Depressive Disorder Unspecified, as confirmed by the MINI 7.02.
Exclusion Criteria:
- Imminent danger to self or others.
- Cognitive impairments with a MOCA score of < 23.
- Bipolar, Psychotic, and Substance-induced Disorders.
- Patients in active treatment of depression who are already on antidepressants, psychotherapy, or both.
Sites / Locations
- Cedars Sinai Medical Center
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Medication Management group
Behavioral Activation Therapy
The medication management group will meet with the patient in a one 50 minute in person introductory antidepressant medication treatment session to educate the patient about depression and medication options. Patients will get prescribed a standard of care anti-depressant medication by treating physician, followed by 12 weekly follow up telephone visits, then on a monthly basis for 3 months, and then as needed thereafter.
BA is an evidence-based psychotherapy with more than 25 randomized trials showing effectiveness in depression. The therapy group will consist of an introductory in person 50-minute treatment session, followed by 12 weekly telephone 50-minute outpatient treatment sessions, then 3 monthly telephone 50-minute outpatient maintenance sessions. A typical BA session will last 50 minutes and include a review of the previous session and completed daily monitoring record forms, an in-depth discussion of life areas and value, and verbal reinforcement of activity engagement.