The MPI-PT Study: Understanding common and differential efficacy patterns of schema therapy and cognitive behavioural therapy in the treatment of depression

Despite new pharmacological and psychotherapeutic treatment options, the course of depressive disorders remains protracted in many cases. In recent years, schema therapy (ST) – a method originally developed for personality disorders, centered around emotion activation – has become very popular and is now also applied to major depressive disorder (MDD). However, its clinical efficacy and neurobiological mediators are still underinvestigated. We present a multimodal, randomized, prospective study (in-patients and day-clinic-patients with MDD) investigating an intense 7-week psychotherapeutic intervention (3 conditions: ST, cognitive behavioural therapy, individualized supportive therapy; each in addition to standard pharmacological treatment). We pursue two main goals: First, to close the gap between the popularity of ST and missing empirical evidence of its efficacy in MDD (symptom level, relapse prevention). Second, to monitor psychometric and biological markers in order to identify treatment-arm specific effects and outcome predictors. Biological markers include polygenic scores, psychophysiological markers, structural and functional MRI (emotion regulation, social interaction) markers, cognitive performance, sleep/activity patterns (actimetry), and autonomous nervous system markers. By combining psychotherapeutic interventions with longitudinal monitoring and biological measurements, we aim to enhance the evidence level of ST as an effective innovative treatment option.