Behavioral Activation (BA) for Medication-responsive Chronically Depressed Patients With Impaired Social Functioning

Psychosocial functioning was assessed before and after BA treatment in medication responsive
depressed individuals who continued to have impaired social functioning. The primary goal
was to demonstrate feasibility of recruitment and retention, and obtain an open pilot sense
as to whether there are benefits from this brief psychotherapy approach in this population.
The investigators also planned to refine measures and estimate the effect size of any
treatment response to estimate power and sample size with the goal of completing a future
controlled study.

Inclusion Criteria:

- adults aged 20-75 years

- a primary diagnosis of Dysthymic Disorder, Chronic major depressive disorder or
double depression

- a >50% decrease in 17 item Hamilton Rating Scale for Depression (HRSD-17) score and a
final HRSD-17 score ≤ 10 with an adequate antidepressant medication (ADM) trial (> 4
weeks on at least 50% Physician's Desk Reference maximum ADM dose)

- a rating of 1 ("very much improved") or 2 ("much improved") on the Clinical Global
Impressions-Improvement scale (CGI-I)

- continued functional impairment, defined by scores >1.9 on the Social Adjustment
Scale (SAS)

- unemployment (jobless, looking for work) according to the Bureau of Labor Statistics:
jobless and looking and available for work, or underemployed.

Exclusion Criteria:

- Structured Clinical Interview for DSM-IV Axis I disorders-diagnosed cognitive or
psychotic disorders

- bipolar disorder

- active eating disorders

- severe borderline personality disorder

- alcohol or drug dependence (except nicotine) in the last 6 months

- current suicide risk

- unstable medical conditions

- use of psychotropic medications other than antidepressants