A parallel group randomised open blinded evaluation of Acceptance and Commitment Therapy for depression after psychosis: pilot trial outcomes (ADAPT)

Gumley, A. et al. (2017) A parallel group randomised open blinded evaluation of Acceptance and Commitment Therapy for depression after psychosis: pilot trial outcomes (ADAPT). Schizophrenia Research, 183, pp. 143-150. (doi:10.1016/j.schres.2016.11.026) (PMID:27894822)

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Abstract

BACKGROUND: Depression is one of the major contributors to poorer quality of life amongst individuals with psychosis and schizophrenia. The study was designed as a Pilot Trial to determine the parameters of a larger, definitive pragmatic multi-centre randomised controlled trial of Acceptance and Commitment Therapy for depression after psychosis (ACTdp) for individuals with a diagnosis of schizophrenia who also meet diagnostic criteria for major depression. METHODS: Participants were required to meet criteria for schizophrenia and major depression. Blinded follow-ups were undertaken at 5-months (end of treatment) and at 10-months (5-months posttreatment). Primary outcomes were depression as measured by the Calgary Depression Scale for Schizophrenia (CDSS) and the Beck Depression Inventory (BDI). RESULTS: A total of 29 participants were randomised to ACTdp + Standard Care (SC) (n=15) or SC alone (n=14). We did not observe significant differences between groups on the CDSS total score at 5-months (Coeff=-1.43, 95%CI -5.17, 2.32, p=0.45) or at 10-months (Coeff=1.8, 95%CI -2.10, 5.69, p=0.36). In terms of BDI, we noted a statistically significant effect in favour of ACTdp+SC at 5-months (Coeff=-8.38, 95%CI -15.49, -1.27, p=0.02) but not at 10-months (Coeff=-4.85, 95%CI -12.10, 2.39, p=0.18). We also observed significant effects on psychological flexibility at 5-months (Coeff=-8.83, 95%CI -14.94, -2.71, p<0.01) but not 10-months (Coeff=-4.92, 95%CI -11.09, 1.25, p=0.11). IMPLICATIONS: In this first RCT of a psychological therapy with depression as the primary outcome, ACT is a promising intervention for depression in the context of psychosis. A further large-scale definitive randomised controlled trial is required to determine effectiveness. TRIAL REGISTRATION: ISRCTN: 33306437.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Clarke, Miss Caoimhe and White, Dr Ross and Lidstone, Dr Emma and Beedie, Dr Sara and Briggs, Professor Andrew and Young, Dr Robin and Macleod, Dr Rachel and Barry, Dr Sarah and Gumley, Professor Andrew and McLeod, Professor Hamish and McTaggart, Miss Jacqueline and Salgado Riveros, Mr Bruno and Ford, Professor Ian and Stewart, Dr Corinna
Authors: Gumley, A., White, R., Briggs, A., Ford, I., Barry, S., Stewart, C., Beedie, S., McTaggart, J., Clarke, C., Macleod, R., Lidstone, E., Salgado Riveros, B., Young, R., and McLeod, H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Schizophrenia Research
Publisher:Elsevier
ISSN:0920-9964
ISSN (Online):1573-2509
Published Online:18 November 2016
Copyright Holders:Copyright © 2016 Elsevier B.V.
First Published:First published in Schizophrenia Research 183: 143-150
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
579891A Parallel group Randomised Open Blinded Evaluation of Acceptance and Commitment Therapy for Depression After Psychosis: A Pilot Trial (ADAPT)Andrew GumleyScottish Executive Health Department (SEHHD-CSO)CZH/4/743IHW - MENTAL HEALTH & WELLBEING