# OptimizeD --- ## **Improving Outcomes for Depression in Primary Care in Low Resource Settings** An ongoing project (2022-current). ![OptimizeD Logo](/sites/g/files/omnuum8326/files/styles/hwp_1_1__360x360_scale/public/mentalhealthlab/files/optimized_logo_cropped.jpg?itok=XMOj7izh) ### The Aim of the Study: OptimizeD, led by **Dr. Vikram Patel (Harvard Medical School) and Steven Hollon (Vanderbilt University)**, aims to improve depression treatment outcomes in primary care in India. As part of the study, we will randomize 1,500 patients with moderate to severe depression to one of two treatments: psychotherapy based on behavioral activation (the [Healthy Activity Program](https://www.google.com/search?q=HAP%20Sangath&rlz=1C5GCCM_en&oq=ha&gs_lcrp=EgZjaHJvbWUqCAgBEEUYJxg7MgYIABBFGDwyCAgBEEUYJxg7Mg4IAhBFGCcYOxiABBiKBTISCAMQLhhDGMcBGNEDGIAEGIoFMgYIBBBFGDwyBggFEEUYPDIGCAYQRRg8MgYIBxBFGDzSAQgyNjk2ajBqN6gCALACAA&sourceid=chrome&ie=UTF-8#:~:text=of%20Epidemiology%20and%C2%A0...-,Healthy%20Activity%20Program,https://sangath.in%20%E2%80%BA%20uploads%20%E2%80%BA%202023/10%20%E2%80%BA%20Healthy-...,-PDF), HAP) or antidepressant medication (fluoxetine). The main goal is to develop a precision treatment rule using baseline patient data to predict in advance which individuals will benefit most from each treatment option. The team will also perform a cost-effectiveness analysis to determine if assigning patients to their optimal treatment is more cost-effective than random assignment. ![OptimizeD background](/sites/g/files/omnuum8326/files/styles/hwp_1_1__720x720_scale/public/mentalhealthlab/files/4.png?itok=Zw6F5D0Y) ### The Background: OptimizeD will be implemented in the Bhopal district, the capital city of Madhya Pradesh, a state in India. The recruitment sites will comprise 6–10 primary healthcare centers, selected from a larger pool of 21 facilities, to ensure diverse population representation. ### The Project Plan: The project will begin with a *Pilot Trial*, in which the team will develop and test the baseline assessment and all the trial procedures, including treatment delivery. The team has estimated that a sample of around 40 participants (i.e., 5 participants from approximately 8 health facilities) would provide sufficient information to refine the processes for the main trial. The Pilot Trial will be followed by the *Main Trial*, in which 1,509 patients will be randomized to either the group receiving HAP or the group receiving antidepressants and will be treated for three months to achieve remission. ### Supporters and Project Duration: This study is funded by the **National Institute of Mental Health**, USA, and will run from **2022 to 2026**. For more information, visit: [OptimizeD | Sangath](https://sangath.in/optimized/) The NIH Clinical Trial Registration can be found [here](https://clinicaltrials.gov/study/NCT05944926?term=%22vikram%20patel%22&rank=4). ### Findings: The Pilot Trial has been completed. Recruitment of 1509 participants was completed on December 31, 2025. The protocol for the main trial was published in BMC Psychiatry (2025). A study on the development of a baseline battery to optimize treatment assignment was published in the Journal of Affective Disorders (2026). Visit the publications section below to learn more. ### Next Steps: The research team plans to complete the data collection for the three-month primary endpoint by March 31, 2026. Data collection for long-term follow-up up to 12 months will be completed by December 31, 2026. ### Publications: - March 2026: [Development of a baseline battery to optimize depression treatment assignment in primary care: Balancing breadth and brevity. Journal of Affective Disorders.](https://drive.google.com/file/d/19Xsh2gAUIs9pQLgzt8JLm1qEoV6btl0J/view?usp=sharing) - July 2025: [Optimizing treatment for depression in primary care using psychotherapy versus antidepressant medication in a low-resource setting: protocol for the OptimizeD randomized controlled trial. BMC Psychiatry.](https://drive.google.com/file/d/1KwxvvpZzZOLwZWHrp1c6CN5SxQ43PCIc/view?usp=sharing) ![PHC visit OptimizeD team](/sites/g/files/omnuum8326/files/styles/hwp_3_2__480x320/public/mentalhealthlab/files/5.png?itok=CegEwrp-) ![OptimizeD team training medical officers](/sites/g/files/omnuum8326/files/styles/hwp_3_2__480x320/public/mentalhealthlab/files/6.png?itok=bTRYR361) ## Investigators and Team Members: ### Project Leadership **Principal Investigators:** Vikram Patel, MD, PhD Paul Farmer Professor and Chair of the Department of Global Health and Social Medicine, Harvard Medical School Steven Hollon, PhD Gertrude Conaway Vanderbilt Professor of Psychology Department of Psychology Vanderbilt University **Site Principal Investigator:** Dr. Anant Bhan, MHSc, MBBS Site PI, Sangath **Project Leads at Harvard Medical School:** John A. Naslund, PhD Instructor in Global Health and Social Medicine Department of Global Health and Social Medicine Harvard Medical School Julia R Pozuelo, PhD Postdoctoral Fellow Department of Global Health and Social Medicine Harvard Medical School **Project Lead at AIIMS Bhopal:** Debasis Biswas, MBBS MD, PDC, MAMS,MNASc, FRC Path Professor and Head of Microbiology, AIIMS **Intervention Coordinators:** Azaz Khan, MA, MSW, PGDHRD Director of Training and Interventions, Sangath Tamonud Moduk, MBBS, MD Assistant Professor, Department of Psychiatry AIIMS Dr. Abhijit Rozatkar, MBBS, MD Additional Professor, Department of Psychiatry AIIMS **NIMH Program Officer:** Holly Campbell-Rosen, Ph.D. Center for Global Mental Health Research National Institute of Mental Health/ NIH ### Key Collaborators (in alphabetical order) Shubham Atal, MBBS, MSc, MD Associate Professor, Department of Pharmacology AIIMS Karmel Choi, PhD Assistant Professor of Psychology, Department of Psychiatry Massachusetts General Hospital Pim Cuijpers, PhD Professor of Clinical Psychology, Department of Behavioural and Movement Sciences Vrije Universiteit Amsterdam Robert DeRubeis, PhD Professor and Director of Clinical Training, Department of Psychology University of Pennsylvania Mohammad Herzallah, PhD Research Scientist, Center for Molecular and Behavioral Neuroscience Rutgers University Ronald Kessler, PhD McNeil Family Professor of Health Care Policy, Department of Health Care Policy Harvard Medical School Chunling Lu, PhD Assistant Professor, Department of Medicine Brigham and Women’s Hospital and Harvard Medical School Daisy Singla, PhD Assistant Professor, Department of Psychiatry University of Toronto Jordan Smoller, MD, SCD Associate Chief for Research, Department of Psychiatry Massachusetts General Hospital Tyler VanderWeele, PhD John L. Loeb and Frances Lehman Loeb Professor of Epidemiology, Department of Epidemiology Havard T.H. Chan School of Public Health ### Research Team (in alphabetical order) Umay Kulsum, PhD Research Scholar AIIMS Arvind Kushwah, MSW Outcome Assessor Coordinator Sangath Anuja Lahiri, PhD Trial Manager, OptimizeD Sangath Yashwant Mehra, PhD Recruitment Supervisor Sangath Kathryn O'Neill, MPH Research Manager, Mental Health For All Lab Department of Global Health and Social Medicine, Harvard Medical School Yashika Parashar, MBBS, MMSc Research Assistant, Mental Health For All Lab Department of Global Health and Social Medicine, Harvard Medical School Varun Shende, MPH Data Manager Sangath Akanksha Shukla, MA HAP coordinator Sangath Rahul S.P. Singh, MPH ADM cum Assistant Research Coordinator Sangath ## Latest Lab News [### Publication: Breaking the Cycle - How Maternal Adversity Shapes Parenting Among Adolescent Mothers in Brazil ](/news/2026/05/publication-breaking-cycle-how-maternal-adversity-shapes-parenting-among-adolescent) May 12, 2026 This publication explores how adverse childhood experiences (ACEs) and intimate partner violence (IPV) shape parenting behaviors among adolescent mothers in Brazil. Drawing on data from 237 mothers aged 14-19 in southern Brazil's public primary care... [Anushka Patel](/people/anushka-patel-phd) [### Announcement: Welcoming Visiting Associate Professor Konstanze Schoeps ](/news/2026/04/announcement-welcoming-visiting-associate-professor-konstanze-schoeps) April 11, 2026 We are delighted to welcome Dr. Konstanze Schoeps , Associate Professor at the University of Valencia and licensed General Health Psychologist, to the Mental Health for All Lab (MHFAL) with Dr. Vikram Patel . 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