University of California, San Francisco
This study aims to assess whether phenotyping-guided intervention selection is superior to intervention selection without phenotyping guidance (i.e., routine clinician and patient judgment regarding treatment selection) for depression.
This study will classify patients seen in the Depression Clinic of the UCSF Department of Psychiatry and Behavioral Sciences into one of five phenotypes (subtypes), including: 1) Anhedonia, 2) Cognitive deficits, 3) Stress sensitivity, 4) Anxious distress, and 5) Grief. After phenotyping, participants will be randomized to receive phenotype-specific intervention (PSI) or care as usual (CAU).
Inclusion Criteria: * Participant is able to provide informed consent * English speaker * 18 years of age or older at time of consent * Meets DSM-5 criteria for Major Depressive Disorder * The subject meets eligibility criteria for at least one study phenotype as determined by assessments, imaging and/or clinical judgment. * PHQ-8 score at baseline of \>= 10 * Scheduled for or completed intake in UCSF outpatient psychiatry Exclusion Criteria: * Unstable or untreated medical or psychiatric condition based on clinical assessment by investigator(s) * Significant risk of suicidal or violent beh…
CAU plan modified to include a trial of pramipexole.
CAU plan modified to include a trial of methylphenidate (or, if contraindicated: guanfacine).
CAU plan modified to include a trial of phenelzine (or, if contraindicated: brexpiprazole).
CAU plan modified to include a trial of MBSST. MBSST is an individual psychotherapy delivered approximately weekly for 16 sessions.
CAU plan modified to include a trial of CGT.
Unmodified CAU plan.
Arctuva estimate
Actual pay is set by the research site.
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