Activation Therapy for Inpatient Depression

Patients with severe depression who require admission to an in-patient psychiatric unit usually have serious impairment in many areas of functioning, particularly cognitive function (memory, concentration, planning). Impaired cognition has significant impacts on the person’s ability to function generally, including performing activities of daily living, occupational and interpersonal functioning.

These cognitive problems do not usually recover with standard treatments but in-patient admission is a chance for patients to receive intensive psychological therapy for these cognitive problems and to accelerate mood response, but such therapy rarely happens, partly because there is limited time and little evidence about what type of therapy helps.

We have designed Activation Therapy (AT), a package of intensive psychological treatment combining cognitive activation (targeted computerised cognitive exercises to improve cognitive performance) with behavioural activation (scheduling and encouraging activity to improve mood). We believe this treatment package may improve outcomes for in-patients with depression, particularly cognitive functioning and general functioning, may speed up mood recovery and reduce the likelihood of re-admission.

The proposed study is a pilot randomised controlled trial to examine the likely effect size difference between the two interventions and to refine the cognitive testing battery to be used in the larger scale study.