COVID-19, Mental Health Disorder
Conditions
Keywords
COVID-19, mental health disorder, cognitive-behavioral therapy, acceptance and commitment therapy, addictive behavior, ICU
Brief summary
The present study is a pilot randomized controlled trial, which identifies and diagnoses mental health problems in survivors of critical COVID-19 infection at 12 months post-ICU care, and randomize patients to either an ACT-enforced CBT intervention, or to treatment as usual.
Detailed description
This is a pilot RCT aiming to intervene in symptoms of poor mental health in COVID survivors at 12 months after ICU care for the COVID infection. Based on the uncertain number of patents who screen positive for mental health problems 12 months after ICU care, based on the novelty of the condition assessed, and the uncertainty about which treatment effects to expect on mental health outcomes, the study was designed as a pilot study, with feasibility measures (consent, adherence and satisfaction with the treatment) as the primary variables, and with effects on mental health symptoms as secondary variables. The study plans to assess and randomize a convenience sample of patients, as it can not be estimated which numbers can be expected, but it is aimed to include at least 40 patients in the study (20 in the intervention group and 20 in the control group). Specifically, the present study aims to 1. investigate early predictors (during ICU-care) of post-covid syndrome occurring at 3-6 months, 12 months, and 36 months, respectively, including cognitive and mental health problems, 2. deepen the understanding of mental health symptoms in ICU-treated COVID-19 survivors, mental health-related treatment seeking, changes in addictive behaviors, and the diagnostic meaning of mental health symptoms expressed in COVID-19 survivors, and 3. conduct a clinical treatment study with the following research question: for patients with post-covid mental health symptoms after 12 months, is an intervention of Cognitive Behavioral Therapy (CBT) with Acceptance and Commitment Therapy (ACT), when compared to standard clinical care (referral to primary care), feasible and associated with improved patient adherence and patient satisfaction, and secondly, does it improve the outcome of post-covid anxiety symptoms and secondary other symptoms of poor mental health and quality of life?
Interventions
BEHAVIORALCBT/ACT
10-session ACT-re-enforced CBT intervention.
Sponsors
Region Stockholm
Lund University
Karolinska Institutet
Region Skane
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Study of a psycho-therapeutic intervention vs treatment as usual, therefore no masking of the treatment given.
Intervention model description
1:1 randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* COVID-19 survivors who screen positive for clinical anxiety or depression, defined as reaching a score of ≥ 8 on either the anxiety or depression sub-scales within the questionnaire HADS at the standard 12-months follow-up
Exclusion criteria
* Conditions in which patients are acutely suicidal, psychotic, suffering from a mental disorder requiring in-patient psychiatric treatment, opposed to receiving a psycho-therapeutic intervention, or with cognitive problems or language difficulties which are judged to be too extensive for the informed consent procedure and for a psycho-therapeutic intervention
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility with respect to willingness for treatment study inclusion | 8 weeks post-assessment | Proportion of patients screened who consent to and initiate the treatment study |
| Feasibility with respect to patient adherence | 2 weeks post-treatment | Proportion of patients who remain in the treatment study including complete treatment settings and 2-week follow-up |
| Patient satisfaction with therapy intervention | 2 weeks post-treatment | Therapy and Therapist Scale-Revised (STTS-R) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Reduced fatigue | 2 weeks, 3 and 12 months post-treatment | Modified Fatigue Impact Scale (MFIS) |
| Reduction of HADS anxiety score | 2 weeks, 3 and 12 months post-treatment | Reduction of HADS anxiety score |
| Reduced post-traumatic symptoms | 2 weeks, 3 and 12 months post-treatment | Posttraumatic Stress Disorder Checklist (PCL-5) scale |
| Reduction of HADS depression score | 2 weeks, 3 and 12 months post-treatment | Reduction of HADS depression score |
| Improved mental health-related quality of life | 2 weeks, 3 and 12 months post-treatment | Improved mental health component summary score of SF-36v2 |
Countries
Sweden
Contacts
Primary ContactAnders Håkansson, PhD
Outcome results
None listed