Treatment
MDD
BLIND
Patients in all three treatment arms were prescribed selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors approved by the Chinese Food and Drug Administration for the treatment of MDD. These medications include paroxetine, sertraline, fluoxetine, fluvoxamine, citalopram, escitalopram, venlafaxine, and duloxetine. The choice of ADM was based on clinician recommendation and the dose could be titrated according to usual practice. The blind assessors documented medication use during the scheduled assessments. Patients were reminded to take their ADM as prescribed and were asked to record their daily use of medication as well as any other concomitant treatments.DIT was based on the Chinese translation of the DIT manual developed by Lemma and colleagues (Lemma et al., GST was also delivered as 16 weekly sessions with each session lasting 45 min. GST is an unstructured and non-directive psychotherapy that was used as an active control to rule out the benefits of common factors in psychological treatment. GST is patient-driven and not theoretically based, and involves the flexible use of basic psychotherapeutic techniques such as empathy, listening, noting and reflecting, eliciting affect, providing reassurance, and focusing on the patient's strengths. The goal of treatment is to strengthen coping resourcefulness and use of adaptive defense mechanisms to manage the demands of the patient's external and internal world. GST did not contain any key elements that are similar to DIT. It was carried out following the unpublished manual developed by our own research team (available from the senior author on request).Among the randomized participants, 84.4% received treatments at the SMHC and 15.6% received treatment at the other sites.