Depression Mental and Behavioural Disorders
Conditions
Interventions
This project will follow a randomised multiple baseline case series design to evaluate if ADepT is feasible, acceptable, and effective in treating depression in those who remain depressed after comple
Sponsors
University of Exeter
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Aged 18+ years old 2. Have not remitted (demonstrated by a PHQ-9 score of =10 to meet NHS Talking Therapies clinical threshold for depression ‘caseness’) to the minimal effective dose (=10 sessions) of high-intensity treatment for depression (as their primary presenting problem) in NHS Talking Therapies within the last 6 months 3. Meet diagnostic criteria for a current episode of MDD (using Structured Clinical Interview for Diagnosis) 4. Sufficient working knowledge of written and spoken English to make use of therapy and complete research assessments without translation 5. Willing for us to notify their General Practitioner of their participation
Exclusion criteria
Exclusion criteria: 1. Currently receiving other psychosocial therapies 2. Individuals who are eligible for, would be seen by, or their needs would be best met by secondary care services 3. Presenting with another area of difficulty that the therapist and/or client believe should be the primary focus of the current intervention 4. Current/past history of schizophrenia or bipolar disorder 5. Displaying marked risk to self (self-harm or suicide) or others that the clinician judges could not be managed safely using weekly therapy in an out-patient setting and that would interfere with engagement in therapy 6. Presenting with features of substance misuse, problematic eating, and/or personality difficulties that the clinician judges could not be managed safely using weekly therapy in an out-patient setting and that would interfere with engagement in therapy 7. Presenting with features of a learning disability that the clinician judges would interfere with engagement in therapy and capacity to complete research assessments 8. Currently lacking capacity to give informed consent 9. Presenting with any other significant, severe or life-threatening disease, disorder, or cognitive impairment that the clinician judges may either put the participants at risk because of participation in the study, may influence the result of the study, or inhibit the participant’s ability to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Recruitment rate measured using the number of clients recruited and over what time frame at the end of the study 2. Treatment engagement measured using the number of clients who completed treatment with a planned discharge and the number of clients attending at least 8 sessions (50% of acute treatment dose), at the end of the acute treatment phase 3. Satisfaction with treatment measured using the number of clients and therapists rating treatment as acceptable, satisfactory and that they would recommend it to others at the end of the acute treatment phase 4. Patient safety measured using the number of serious incidents that could be clearly attributed to the intervention or research participation at the end of the study 5. Preliminary signal of clinical efficacy, indexed as the number of clients showing at least reliable improvement and/or a positive change in slope/level in time series analysis of depression, anxiety and/or wellbeing (see list of secondary outcome measures below for details), measured at the end of the acute treatment phase | — |
Secondary
| Measure | Time frame |
|---|---|
| The following clinical outcome measures will be collected weekly during the baseline, treatment, and 2-month post treatment phase: 1. Current depression symptom severity over the past week measured using the Patient Health Questionnaire (PHQ-9) 2. Positive wellbeing experiences over the past week measured using the Warwick-Edinburgh Mental Wellbeing Scale long form (WEMWBS-LF) 3. Anxiety symptom severity (given depression is frequently comorbid with anxiety) measured using the Generalized Anxiety Disorder scale (GAD-7) 4. Psychosocial impairment as a result of poor mental health measured using the Work and Social Adjustment Scale (WSAS) The following clinical outcome measures will be collected at intake, pre-treatment, post-treatment, 2-month follow-up and 1-year follow-up extended assessment: 1. PHQ-9, GAD-7, WSAS and WEMWBS-LF as described above 2. Anhedonia severity (a loss of interest and pleasure) measures using the Snaith Hamilton Pleasure Scale (SHAPS) 3. Satisfaction in key life domains measured using the DIALOG scale 4. The recovery of quality of life for people with mental health difficulties measured using the Recovering Quality of Life tool (ReQoL-10) 5. The logic model underpinning the ADepT intervention measured using the ADepT Outcome Tool 6. Positive and negative emotions for clients from week-to-week as they engage in everyday life measured using the Positive and Negative Affect Scale (Short-form; SF-PANAS) 7. Attitudes toward savouring positive experiences measured using the self-report Savouring Beliefs Inventory (SBI) | — |
Countries
England, United Kingdom
Contacts
Public ContactBarney Dunn
Outcome results
None listed