The Library
Behavioural activation versus guided self-help for depression in adults with learning disabilities : the BeatIt RCT
Tools
Jahoda, Andrew, Hastings, Richard P., Hatton, Chris, Cooper, Sally-Ann, McMeekin, Nicola, Dagnan, Dave, Appleton, Kim, Scott, Katie, Fulton, Lauren, Jones, Robert, McConnachie, Alex, Zhang, Rachel, Knight, Rosie, Knowles, Dawn, Williams, Christopher, Briggs, Andy and Melville, Craig (2018) Behavioural activation versus guided self-help for depression in adults with learning disabilities : the BeatIt RCT. Health Technology Assessment, 22 (53). pp. 1-130. doi:10.3310/hta22530 ISSN 1366-5278.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://dx.doi.org/10.3310/hta22530
Abstract
Background
Depression is the most prevalent mental health problem among people with learning disabilities.
Objective
The trial investigated the clinical effectiveness and cost-effectiveness of behavioural activation for depression experienced by people with mild to moderate learning disabilities. The intervention was compared with a guided self-help intervention.
Design
A multicentre, single-blind, randomised controlled trial, with follow-up at 4, 8 and 12 months post randomisation. There was a nested qualitative study.
Setting
Participants were recruited from community learning disability teams and services and from Improving Access to Psychological Therapies services in Scotland, England and Wales.
Participants
Participants were aged ≥ 18 years, with clinically significant depression, assessed using the Diagnostic Criteria for Psychiatric Disorders for use with Adults with Learning Disabilities. Participants had to be able to give informed consent and a supporter could accompany them to therapy.
Interventions
BeatIt was a manualised behavioural activation intervention, adapted for people with learning disabilities and depression. StepUp was an adapted guided self-help intervention.
Main outcome measures
The primary outcome measure was the Glasgow Depression Scale for people with a Learning Disability (GDS-LD). Secondary outcomes included carer ratings of depressive symptoms and aggressiveness, self-reporting of anxiety symptoms, social support, activity and adaptive behaviour, relationships, quality of life (QoL) and life events, and resource and medication use.
Results
There were 161 participants randomised (BeatIt, n = 84; StepUp, n = 77). Participant retention was strong, with 141 completing the trial. Most completed therapy (BeatIt: 86%; StepUp: 82%). At baseline, 63% of BeatIt participants and 66% of StepUp participants were prescribed antidepressants. There was no statistically significant difference in GDS-LD scores between the StepUp (12.94 points) and BeatIt (11.91 points) groups at the 12-month primary outcome point. However, both groups improved during the trial. Other psychological and QoL outcomes followed a similar pattern. There were no treatment group differences, but there was improvement in both groups. There was no economic evidence suggesting that BeatIt may be more cost-effective than StepUp. However, treatment costs for both groups were approximately only 4–6.5% of the total support costs. Results of the qualitative research with participants, supporters and therapists were in concert with the quantitative findings. Both treatments were perceived as active interventions and were valued in terms of their structure, content and perceived impact.
Limitations
A significant limitation was the absence of a treatment-as-usual (TAU) comparison.
Conclusions
Primary and secondary outcomes, economic data and qualitative results all clearly demonstrate that there was no evidence for BeatIt being more effective than StepUp.
Item Type: | Journal Article | ||||
---|---|---|---|---|---|
Divisions: | Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR) | ||||
Journal or Publication Title: | Health Technology Assessment | ||||
Publisher: | NIHR Health Technology Assessment programme | ||||
ISSN: | 1366-5278 | ||||
Official Date: | September 2018 | ||||
Dates: |
|
||||
Volume: | 22 | ||||
Number: | 53 | ||||
Page Range: | pp. 1-130 | ||||
DOI: | 10.3310/hta22530 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |