Feasibility of a randomised controlled trial of remotely delivered problem-solving cognitive behaviour therapy versus usual care for young people with depression and repeat self-harm: lessons learnt (...

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dc.contributor.authorSayal, Kapil
dc.contributor.authorRoe, James
dc.contributor.authorBall, Harriet
dc.contributor.authorAtha, Christopher
dc.contributor.authorKaylor-Hughes, Catherine
dc.contributor.authorGuo, Boliang
dc.contributor.authorTownsend, Ellen
dc.contributor.authorMorriss, Richard
dc.date.accessioned2020-06-08T14:41:15Z
dc.date.available2020-06-08T14:41:15Z
dc.date.issued0000-00-00
dc.description.abstractBACKGROUND Self harm and depression are strong risk factors for repeat self harm and suicide We aimed to investigate the feasibility of a randomised controlled trial RCT of remotely delivered problem solving cognitive behaviour therapy PSCBT plus treatment as usual TAU versus TAU in young people with repeat self harm and depression METHODS Single blind multi centre RCT with an internal pilot pre set stop go criteria and qualitative semi structured interviews Eligible participants aged 16 30 years were recruited from 9 adult or child and adolescent self harm and crisis services had 2 lifetime self harm episodes one in the preceding 96 h and Beck Depression Inventory II BDI II score 17 Participants were randomised 1 1 to either TAU or TAU and 10 12 sessions of PSCBT delivered by mobile phone or video calling RESULTS Twenty two participants were recruited 11 in each arm 10 46 completed follow up at 6 months 9 82 started the PSCBT and 4 36 completed it The study did not meet three of its four stop go criteria reflecting considerable barriers to recruitment and retention Participants had severe depression symptoms with mean BDI II 38 9 in the PSCBT and 37 2 in TAU groups respectively Three 14 unblindings occurred for immediate safety concerns Barriers to recruitment and retention included lack of agency for participants severity of depression recency of crisis with burden for participants and clinicians who diagnosed depression according to pervasiveness CONCLUSIONS RCTs of PSCBT for young people with depression and self harm are not feasible using recruitment through mental health services that conduct assessments following self harm presentations Clinician assessment following self harm presentation mainly identifies those with severe rather than mild moderate depression TRIAL REGISTRATION ClinicalTrials gov NCT02377011 Date of registration March 3rd 2015 Retrospectively registered within 21 days of recruitment of the first participant
dc.identifier.urihttp://dx.doi.org/10.1186/s12888-018-2005-3
dc.identifier.urihttps://lib.digitalsquare.io/handle/123456789/65016
dc.relation.uriBMC psychiatry
dc.titleFeasibility of a randomised controlled trial of remotely delivered problem-solving cognitive behaviour therapy versus usual care for young people with depression and repeat self-harm: lessons learnt (...en
dcterms.abstractBACKGROUND Self harm and depression are strong risk factors for repeat self harm and suicide We aimed to investigate the feasibility of a randomised controlled trial RCT of remotely delivered problem solving cognitive behaviour therapy PSCBT plus treatment as usual TAU versus TAU in young people with repeat self harm and depression METHODS Single blind multi centre RCT with an internal pilot pre set stop go criteria and qualitative semi structured interviews Eligible participants aged 16 30 years were recruited from 9 adult or child and adolescent self harm and crisis services had 2 lifetime self harm episodes one in the preceding 96 h and Beck Depression Inventory II BDI II score 17 Participants were randomised 1 1 to either TAU or TAU and 10 12 sessions of PSCBT delivered by mobile phone or video calling RESULTS Twenty two participants were recruited 11 in each arm 10 46 completed follow up at 6 months 9 82 started the PSCBT and 4 36 completed it The study did not meet three of its four stop go criteria reflecting considerable barriers to recruitment and retention Participants had severe depression symptoms with mean BDI II 38 9 in the PSCBT and 37 2 in TAU groups respectively Three 14 unblindings occurred for immediate safety concerns Barriers to recruitment and retention included lack of agency for participants severity of depression recency of crisis with burden for participants and clinicians who diagnosed depression according to pervasiveness CONCLUSIONS RCTs of PSCBT for young people with depression and self harm are not feasible using recruitment through mental health services that conduct assessments following self harm presentations Clinician assessment following self harm presentation mainly identifies those with severe rather than mild moderate depression TRIAL REGISTRATION ClinicalTrials gov NCT02377011 Date of registration March 3rd 2015 Retrospectively registered within 21 days of recruitment of the first participant
dcterms.contributorSayal, Kapil
dcterms.contributorRoe, James
dcterms.contributorBall, Harriet
dcterms.contributorAtha, Christopher
dcterms.contributorKaylor-Hughes, Catherine
dcterms.contributorGuo, Boliang
dcterms.contributorTownsend, Ellen
dcterms.contributorMorriss, Richard
dcterms.identifierhttp://dx.doi.org/10.1186/s12888-018-2005-3
dcterms.relationBMC psychiatry
dcterms.titleFeasibility of a randomised controlled trial of remotely delivered problem-solving cognitive behaviour therapy versus usual care for young people with depression and repeat self-harm: lessons learnt (...en
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