• Hamilton Depression Rating Scale [ Time Frame: Before treatment, at treatment termination (16 weeks) and at 1 and 2 year follow-up ] [ Designated as safety issue: No ]
  

• Outcome Questionnaire - 45 [ Time Frame: Before treatment, after session 8, at treatment termination (16 weeks) and at 1 and 2 year follow-up ] [ Designated as safety issue: No ]
  

Interpersonal Therapy (IPT; Klerman et al., 1984) and Brief Relational Therapy (BRT; Safran & Muran, 2000) are both brief psychotherapies based on interpersonal theory, but differ mainly in type of relational focus. IPT is mainly focused on helping the patient solve specific interpersonal problems in the patient's life outside therapy that are thought to maintain the patient's depression. At Linköping University the first formal training in IPT in Sweden is given. Therapists are trained for two years in IPT and Brief Relational Therapy (BRT), the latter being a treatment based on attachment theory, relational psychoanalysis and research on ruptures and resolution of the therapeutic alliance. BRT thus resembles IPT in its theoretical roots, but differs in being more focussed on exploration of the therapy relationship than on interpersonal relationships outside therapy. Patients with Major Depressive Disorder are randomized to 16 sessions of either IPT or BRT (slightly modified for depression treatment). All therapists provide both treatments, thus controlling for general therapist effects. Outcome measures include the SCID-I and II, Hamilton Depression Rating Scale, Patient Health Questionnaire - 9, Outcome Questionnaire - 45, Inventory of Interpersonal Problems, Depressive Experiences Questionnaire, Five Facet Mindfulness Inventory and Quality of Life Inventory. In addition, the Adult Attachment Interview will be administered at therapy start, termination and follow-up and scored with the Reflective Functioning Scale. Also, a separate symptom-specific RF scale designed to measure reflection on depressive symptoms is used. Process measures (filled out by both therapist and patient) include the Working Alliance Inventory (12-item version) and the Feeling Checklist, and are scored by both therapist and patient after each session. All sessions, including assessment sessions, are video recorded, allowing for competence ratings and detailed process research. The study fulfils several purposes; it tests BRT against a treatment with already established efficacy and allows for testing hypothesized interaction effects between treatment modality and patient characteristics.