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This research is to study the effectiveness of cognitive behavioral therapy-CBT and Psychotherapy by trained buddhist monks. There are generally accepted that both cognitive and Buddhist concepts are related. This randomized controlled trial is to study the elderly participants who suffer major depressive disorder according to DSM-IV. The subjects will be divided into two groups. The experimental group will receive 12 sessions of CBT 2 times per week for 6 weeks in addition to usual treatment. The control group will receive treatment as usual and general conversation (non-CBT) with monks. Pretreatment factors (such as attachment style, interpersonal factors) of both therapist monks and patient participants will be studied.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAU plus Cognitive-behavioral Therapy | Active Comparator | Participants randomized to this group will receive treatment as usual plus cognitive behavioral therapy (CBT) provided by trained Buddhist monks. |
|
| TAU plus routine counselling | Sham Comparator | Participants randomized into this group will receive treatment as usual (TAU) plus plus routine psychological support from non-CBT monks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Treatment as usual | Behavioral | Treatment as usual (TAU)is defined as the routine care provided to each individual patient at the geriatric psychiatry clinic of Maharaj Nakorn Chiang Mai Hospital. |
| Measure | Description | Time Frame |
|---|---|---|
| Evidence of clinically depression confirmed by clinician | Depression will be assessed by HAMD-7 (McIntyre, 2005) | 2 months after the end of the intervention |
| Depression- self report | depression will be assessed by Geriatric Depression Scale (GDS)(Shiekh & Yesavage, 1986) | 2 month after the end of the inetrvention |
| Measure | Description | Time Frame |
|---|---|---|
| Dimensional psychological distress (anxiety, depression,and somatization) | anxiety, depression,and somatization symptom will be assessed by the Core symptom index (CSI) (Wongpakaran, unpublished), | week 6, 12, 20 |
| Dimensional psychological distress ( perception of stress) |
| Measure | Description | Time Frame |
|---|---|---|
| working alliance | Working alliance will be assessed by the Helping Alliance Questionnaire (HAQ)(Luborsky, 1996) | after session 3, 6, and 12 |
| Pretreatment measure (attachment) | The part includes participants' attachment which will be assessed by the revised Experience of Close Relationships Questionnaire (ECR-R 18)(Wongpakaran, 2012) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nahathai - Wongpakaran, M.D. | Contact | +66 53 945422 | 320 | nkuntawo@med.cmu.ac.th |
| Name | Affiliation | Role |
|---|---|---|
| Nahathai - Wongpakaran, M.D. | Chiang Mai University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geriatric clinic, Maharaj Nakorn Chiang Mai Hospital | Chiang Mai | Chiang Mai | 50200 | Thailand |
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| ID | Term |
|---|---|
| D003865 | Depressive Disorder, Major |
| D003863 | Depression |
| ID | Term |
|---|---|
| D003866 | Depressive Disorder |
| D019964 | Mood Disorders |
| D001523 | Mental Disorders |
| D001526 | Behavioral Symptoms |
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| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D015928 | Cognitive Behavioral Therapy |
| ID | Term |
|---|---|
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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|
| Cognitive-behavioral therapy | Behavioral | Cognitive behavioral therapy(CBT)includes psychoeducational components combined with cognitive interventions targeted at challenging negative automatic thoughts. |
|
Perception of stress will be assessed by Perceived Stress Scale-10 (PSS-10) (Cohen 1983 ; Wongpakaran, 2010) |
| Week 6, 12, 20 |
| at baseline |
| Pretreatment measure (interpersonal problems) | Interpersonal problems will be assessed by the inventory of interpersonal problems(Horowitz, 2000) | at baseline |
| Pretreatment measure(neuroticism) | Neuroticism will be assessed by the Neuroticsm Inventory (Wongpakaran,unpublished) | at baseline |
| D001519 |
| Behavior |