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Dynamic Networks in Depression Treatment: Mechanisms of Change in Pharmacological, Psychological and Combined Treatment of Depression

Phase IV Interventional Depression - Major Depressive Disorder

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Psychopharmacological treatment, Cognitive-behavioral group treatment (CBGT-D).
Who it may be relevant to
Registry conditions: Depression - Major Depressive Disorder. Basic parameters: 18 years — 65 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
Germany
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

Unsure about the terms? Read our patient guide →

Official title

Veränderungen Dynamischer Symptom-Netzwerke Unter Pharmakologischer, Psychotherapeutischer Und Kombinierter Behandlung Bei Depression (DYNDET)

Overview

This study investigates how antidepressant pharmacotherapy, cognitive-behavioral therapy, or their combination modulate the temporal dynamics and connectivity of depressive symptom networks. Using intensive longitudinal ecological momentary assessment data, the trial examines treatment-specific changes in symptom interactions. By applying network-based analytic approaches, the study aims to elucidate differential and potentially complementary mechanisms of change across treatment modalities. Findings may contribute to more informed and individualized treatment strategies for major depressive disorder.

Interventions

  • Drug Psychopharmacological treatment
    Participants will receive outpatient treatment with escitalopram. Treatment will be initiated at 5 mg/day for three days and increased to a target dose of 10 mg/day. Clinical re-evaluations will take place after two and four weeks. In case of insufficient clinical response, the dose may be increased to 15 mg/day in accordance with guideline recommendations.
  • Behavioral Cognitive-behavioral group treatment (CBGT-D)
    Consisting of a group treatment of the same time frame as the psychopharmacological treatment and includes the following components: psychoeducation, behavioral activation, cognitive restructuring, social problem-solving, homework assignments and relapse prevention.

Primary outcome measures

  • Structure of symptom networks via multilevel vector autoregressive modeling (mlVAR) [Time frame: From Baseline (2 weeks) to immediately Post-Treatment (11 weeks)]
Secondary outcome measures (10)
  • Hamilton rating scale for depression (HAM-D) [Time frame: From Inclusion to immediately Post-Treatment (11 weeks)]
  • Montgomery-Åsberg Depression Rating Scale (MADRS) [Time frame: From Inclusion to immediately Post-Treatment (11 weeks)]
  • The Inventory of Depressive Symptomatology clinician (IDS-C) [Time frame: From Inclusion to immediately Post-Treatment (11 weeks)]
  • Social and Occupational Functioning Assessment Scale (SOFAS) [Time frame: Immediately at Inclusion]
  • Positive and Negative Affect Schedule - Short Form (PANAS-SF) [Time frame: From Inclusion to immediately Mid-Treatment (7 weeks)]
  • Perseverative Thinking Questionnaire (PTQ) [Time frame: From Inclusion to immediately Mid-Treatment (7 weeks)]
  • The Acceptance and Action Questionnaire (AAQ-2) [Time frame: From Inclusion to immediately Mid-Treatment (7 weeks)]
  • Fragebogen zur sozialen Unterstützung (F-SozU) [Time frame: From Inclusion to immediately Mid-Treatment (7 weeks)]
  • Couples Satisafction Index (CSI-4) [Time frame: From Inclusion to immediately Mid-Treatment (7 weeks)]
  • Perceived Deficits Questionnaire - Depression (PDQ-D) [Time frame: From Inclusion to immediately Mid-Treatment (7 weeks)]

Eligibility criteria

Inclusion criteria

  • Depressive disorder (mild to moderate symptom severity)
  • 18-65 years
  • must own a smartphone with internet access

Exclusion criteria

  • severe depressive episode
  • acute suicidality,
  • bipolar disorder,
  • substance use disorder
  • psychotic depression
  • severe medical or neurological illness
  • insufficient german language skills
  • concurrent psychotherapeutic treatment
  • conditions that may interfere with fMRI

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Single blind
Primary purpose
Treatment

Study locations

Germany · 3 centers
  • Clinical Psychology and Psychotherapy — Frankfurt
  • Department of Psychiatry, Psychosomatics and Psychotherapy — Frankfurt
  • Department of Psychiatry and Psychotherapy — Marburg

Identifiers

NCT: NCT07488910 · 2025-2718

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗