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

SCHIZOPHRENIA RESEARCH

卷:183

Article

Gumley, Andrew¹  White, Ross^1,2  Briggs, Andy³  Ford, Ian⁴  Barry, Sarah⁴  Stewart, Corinna¹  Beedie, Sara¹  McTaggart, Jacqueline⁵  Clarke, Caoimhe¹  MacLeod, Rachel⁵  Lidstone, Emma⁵  Riveros, Bruno Salgado³  Young, Robin⁴  McLeod, Hamish¹ 

[1] Univ Glasgow, Inst Hlth & Wellbeing, Mental Hlth & Wellbeing, Glasgow, Lanark, Scotland

[2] Univ Liverpool, Inst Psychol Hlth & Soc, Liverpool, Merseyside, England

[3] Univ Glasgow, Inst Hlth & Wellbeing, Hlth Econ & Hlth Technol Assessment, Glasgow, Lanark, Scotland

[4] Univ Glasgow, Inst Hlth & Wellbeing, Robertson Ctr Biostat, Glasgow, Lanark, Scotland

[5] NHS Greater Glasgow & Clyde, Glasgow, Lanark, Scotland

关键词: Schizophrenia;    Depression;    Randomised controlled trial;    Pilot;    Acceptance and Commitment Therapy;   

DOI  :  10.1016/j.schres.2016.11.026

来源: Elsevier

【 摘 要 】

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 (C) 2016 Published by Elsevier B.V.

【 授权许可】

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