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Randomized Controlled Trial
. 2017 May:183:143-150.
doi: 10.1016/j.schres.2016.11.026. Epub 2016 Nov 25.

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

Andrew Gumley  1 , Ross White  2 , Andy Briggs  3 , Ian Ford  4 , Sarah Barry  4 , Corinna Stewart  5 , Sara Beedie  5 , Jacqueline McTaggart  6 , Caoimhe Clarke  5 , Rachel MacLeod  6 , Emma Lidstone  6 , Bruno Salgado Riveros  3 , Robin Young  4 , Hamish McLeod  5
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Free article
Randomized Controlled Trial

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

Andrew Gumley et al. Schizophr Res. 2017 May.
Free article

Abstract

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.

Keywords: Acceptance and Commitment Therapy; Depression; Pilot; Randomised controlled trial; Schizophrenia.

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