Conventional vs. Religious Psychotherapy for Major Depression in Patients with Chronic Illness

This project is the initial first step in developing a research program and bringing together a team of investigators capable of conducting future studies to uncover the biological mechanisms that explain why religion affects physical health and longevity. Our target here is depression: a prototype disorder that is (1) widespread, (2) causes tremendous functional disability, (3) produces adverse immune and endocrine changes with clinical consequences, (4) is influenced by genetics, and (5) is influenced both in its development and course by religious involvement. In partnership with University of London, we propose a RCT of conventional (CCBT) vs. religious cognitive behavior therapy (RCBT) for major depression in medical patients with chronic disabling illness. Therapists will deliver the treatment in real time over the Internet and/or by telephone. In Phase I (Rounsaville 1a) we will conduct an open trial of 30 patients to assess subject recruitment, develop & refine treatment manuals (Christian, Jewish, Hindu, Buddhist, and Muslim versions of the RCBT manual will be developed, with CBT experts in these traditions supervising therapists), assess compliance with and acceptability of treatment, and identify the best delivery system, as well as give therapists experience in that delivery system. In Phase II (Rounsaville 1b) we will conduct a randomized proof of concept comparison of CCBT vs. RCBT that will demonstrate feasibility and confirm the expected clinically meaningful difference for a definitive NIH application. In Phase II, 70 religious patients (primarily Christian) will be randomized to receive ten 50 min sessions delivered over 12 weeks of either CCBT or RCBT. Of particular importance, we will examine the effects of genetic variation at candidate genes (serotonin transporter, 5-HT1A receptor, and monoamine oxidase A promoter) on treatment response, and compare the effects of RCBT vs. CCBT on endocrine and immune measures in blood and urine.

Grant Amount:

$1,220,386

Start Date:

April 2011

End Date:

March 2014

Grant ID:

21399