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Trial registered on ANZCTR
Registration number
ACTRN12606000101583
Ethics application status
Approved
Date submitted
14/03/2006
Date registered
15/03/2006
Date last updated
20/08/2007
Type of registration
Prospectively registered
Titles & IDs
Public title
The DEPTH Project: Detection, Evaluation, and Psychological Therapy for Health
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Scientific title
Randomised controlled trial of cognitive behaviour therapy to prevent psychosis among people with at-risk mental states
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Universal Trial Number (UTN)
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Trial acronym
DEPTH
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ultra-high risk for the development of a psychotic disorder
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Condition category
Condition code
Mental Health
1145
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0
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Psychosis and personality disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study intervention is Cognitive Behaviour Therapy. This treatment will follow that employed by Morrison and colleagues in the EDIE trial, as described in the manual for that trial. Interventions are tailored to address the problems identified by the patients and are based on shared formulations. Therapists encourage collaborative empiricism, use guided discovery and recommend homework. However, this form of CBT differs somewhat from other forms in that it is designed specifically for preventing transition to psychosis among young high-risk individuals. Problems of substance use and dependence will be addressed with the techniques of motivational interviewing and CBT developed by Baker and Bucci for substance problems among people with psychoses.
Duration of treatments: 26 therapy (weekly) sessions
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Intervention code [1]
939
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Treatment: Other
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Comparator / control treatment
The control intervention is Non-Directive Reflective Listening: this is a form of person-centred counselling in which, within a therapeutic setting, the therapist offers empathic reflections while adopting a stance of genuineness or congruence and unconditional positive regard. Patients will be invited to discuss any topics they wish, not necessarily issues related to at-risk mental states, and the direction of content throughout the treatment will be for the patients to determine.
Duration of treatments: 26 therapy (weekly) sessions
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome will be length of survival without the development of levels of positive psychotic symptoms of such severity that they mark a threshold at which anti-psychotic medication would normally be commenced. This severity threshold is defined as ratings in the psychotic range on the Comprehensive Assessment of At-Risk Mental States (CAARMS) positive items with frequencies of 3 to 6 times a week, plus the symptoms have persisted for more than one week. The development of mania, dangerous behaviour, or suicidality, defined as ratings of 5 or more on the corresponding scales of the CAARMS, will also be regarded as a transition and will also constitute a cue for the commencement of appropriate medication (Transition to psychosis).
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Assessment method [1]
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Timepoint [1]
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Formally assessed once a month for the first 6 months and once every 2 months for the next 6 months
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Secondary outcome [1]
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Group differences in rates of change of symptoms assessed by the CAARMS.
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Assessment method [1]
2778
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Timepoint [1]
2778
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Formally assessed once a month for the first month and once every two months for the next 6 months.
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Secondary outcome [2]
2779
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Group differences in rates of change of substance use assessed by the OTI.
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Assessment method [2]
2779
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Timepoint [2]
2779
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Formally assessed once a month for the first month and once every two months for the next 6 months.
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Secondary outcome [3]
2780
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Group differences in rates of change of social functioning assessed by the Quality of Life Scale.
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Assessment method [3]
2780
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Timepoint [3]
2780
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Formally assessed once a month for the first month and once every two months for the next 6 months.
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Eligibility
Key inclusion criteria
reside within the boundaries of the Hunter New England Health Area or the former Mid-Western region of the Greater Western Area Health Service, meet criteria for one or more of 3 ‘at-risk mental states’ (ARMS). These three groups are operationally defined as follows: Group A (state and trait risk factors): A combination of a first-degree relative with a history of any psychotic disorder, or the patient meets DSM-IV criteria for a diagnosis of schizotypal personality disorder, and any change in mental state or functioning which has resulted in a loss of at least 30% on the Global Assessment of Functioning scale for at least one month. Group B (attenuated psychotic symptoms): The person has developed one or more prodromal symptoms which represent a change in their functioning, different from their normal personality, and which occur with a frequency of at least several times a week and have been occurring for at least one week. The symptoms include ideas of reference, odd beliefs or magical thinking, perceptual disturbance, suspiciousness or paranoid thinking, and behaviour that is odd, eccentric or peculiar. The symptoms must deviate significantly from normal, as defined by ratings in the prodromal range on the Comprehensive Assessment of At Risk Mental States (CAARMS). Group C (transient psychotic symptoms): The person has a history during the previous year of brief limited intermittent psychotic symptoms (BLIPS) lasting less than one week before resolving spontaneously. The symptoms are defined by the presence of one or more ratings in the psychotic range on the CAARMS positive items: disorders of thought content, perceptual abnormalities, disorganised speech.
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Minimum age
12
Years
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Maximum age
30
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Meet criteria for a past or current DSM-IV psychotic disorder, have previously been prescribed anti-psychotic medication, have an organic mental disorder or intellectual disabilities, are at serious suicidal or homicidal risk (they will be eligible for inclusion once this risk has resolved), have an inadequate command of the English language.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone/email
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified by gender, site, and receipt of antidepressant medication, using a system of central and external randomisation.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
18/04/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
78
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health & Medical Research Council Project Grant
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Address [1]
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Level 5, 20 Allara Street
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Prof. Mike Startup, University of Newcastle
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Address
School of Psychology, University of Newcastle, NSW 2308
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Prof. Vaughan Carr
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Address [1]
1107
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Centre for Brain and Mental Health Research, University of Newcastle, 2300
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Country [1]
1107
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Australia
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Secondary sponsor category [2]
1108
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Individual
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Name [2]
1108
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A/Prof Amanda Baker
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Address [2]
1108
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Centre for Brain and Mental Health Research, University of Newcastle, 2300
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Country [2]
1108
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Australia
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Secondary sponsor category [3]
1109
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Individual
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Name [3]
1109
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A/Prof Ulrich Schall
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Address [3]
1109
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Centre for Brain and Mental Health Research, University of Newcastle, 2300
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Country [3]
1109
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Australia
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Secondary sponsor category [4]
1110
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Individual
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Name [4]
1110
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Dr Helen Stain
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Address [4]
1110
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Centre for Rural and Remote Mental Health, Broomfield Hospital, Orange, NSW
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Country [4]
1110
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
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Locked Bag No 1, New Lambton, NSW 2305
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
2582
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Approval date [1]
2582
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23/02/2006
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Ethics approval number [1]
2582
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05/12/07/3.23
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Ethics committee name [2]
2583
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Human Research Ethics Committee of the University of Newcastle
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Ethics committee address [2]
2583
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Ethics committee country [2]
2583
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Australia
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Date submitted for ethics approval [2]
2583
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01/12/2005
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Approval date [2]
2583
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15/02/2006
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Ethics approval number [2]
2583
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H-183-0206
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Ethics committee name [3]
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Human Research Ethics Committee of the Greater Western Area Health Service
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Ethics committee address [3]
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PO Box 143, The Lodge, Gorman's Hill Road, Bathurst, NSW 2795
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Ethics committee country [3]
2584
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Australia
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Date submitted for ethics approval [3]
2584
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20/03/2006
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Approval date [3]
2584
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17/07/2006
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Ethics approval number [3]
2584
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GW2006/04
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Summary
Brief summary
The study will compare the effectiveness of cognitive behaviour therapy (CBT) and a non-directive psychotherapy matched for therapist input in delaying or preventing transition to psychosis among young people at high risk for psychosis. It is expected that patients assigned to CBT will: (1) show lower rates of transition to psychosis during the 12-month follow-up period; (2) survive longer without becoming psychotic even if they do make a transition during the 12-month follow-up period; (3) show better outcomes at 6 and 12 months in terms of psychotic and non-psychotic symptoms, quality of life and social functioning, whether or not they become psychotic.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Mr Sean Halpin
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Address
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Psychological Assistance Service
Hunter Health Service
43 Brunker Road
Broadmeadow NSW 2292
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Country
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Australia
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Phone
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+61 2 49610431
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Fax
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+61 2 49610435
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Mike Startup
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Address
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School of Psychology
University of Newcastle
Callaghan NSW 2308
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Country
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Australia
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Phone
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+61 2 49215979
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Fax
1056
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+61 2 49216980
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Email
1056
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A randomised controlled trial of cognitive behaviour therapy versus non-directive reflective listening for young people at ultra high risk of developing psychosis: The detection and evaluation of psychological therapy (DEPTh) trial.
2016
https://dx.doi.org/10.1016/j.schres.2016.08.008
N.B. These documents automatically identified may not have been verified by the study sponsor.
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