Plain English Summary
Background and study aims
Learning disabilities are common conditions which affect the way people’s minds are able to process information and learn (intellectual ability). Even in a mild form, they can make everyday activities more difficult, causing problems with household tasks, socialising or managing money. It has been found that many people suffering from a mild learning disability also experience problems with their mood, such as depression (extreme sadness) and anxiety. Cognitive behavioural therapy (CBT) is a type of talking therapy, which works by teaching people more effective ways to deal with their problems by changing the way they think and behave. Many studies have shown that CBT can be an extremely effective therapy for people suffering from problems with their mood, however little research has been done to find out whether this type of treatment could be effective for someone with mild learning disabilities. Studies have shown that people with mild learning disabilities have the skills needed to take part in CBT. The aim of this study is to test the effectiveness of CBT in treating those with mild learning disabilities that are experiencing problems with their mood.
Who can participate?
Adults with mild learning disabilities who are also experiencing mental health problems that affect their mood (such as depression or anxiety).
What does the study involve?
Participants are randomly allocated to one of two groups. Participants in the first group receive weekly one-to-one sessions of CBT for up to 16 weeks. These participants also continue to receive the usual service that they receive from the intellectual disability service, involving care management and emotional and social support. Participants in the second group continue to receive the usual service from the intellectual disability service, but do not receive any additional support throughout the 16 weeks of the study. At the start of the study and then again after 4 and 6 months, participants in both groups complete a number of questionnaires in order to find out whether the treatment has made any changes to their mood, quality of life or thinking ability (cognitive aspects).
What are the possible benefits and risks of participating?
Not provided at time of registration
Where is the study run from?
Camden and Islington Mental Health and Social Care Trust (UK)
When is the study starting and how long is it expected to run for?
March 2010 to August 2011
Who is funding the study?
National Institute for Health Research (UK)
Who is the main contact?
Dr Angela Hassiotis
a.hassiotis@ucl.ac.uk
Trial website
http://www.ucl.ac.uk/mentalhealthsciences/researchthemesandinterests/cbt
Contact information
Type
Scientific
Primary contact
Dr Angela Hassiotis
ORCID ID
Contact details
University College London
Department of Mental Health Sciences
Charles Bell House
67-73 Riding House Street
London
W1W 7EJ
United Kingdom
+44 (0)20 7974 3737/88
a.hassiotis@ucl.ac.uk
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
PB-PG-0807-14121
Study information
Scientific title
Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): a randomised controlled trial
Acronym
Study hypothesis
Is manualised cognitive behavioural therapy (CBT) treatment more clinically and cost effective than treatment as usual (TAU) for depression and/or anxiety for people with mild intellectual disabilities?
Ethics approval
The Joint UCL/UCLH Committees on Ethics of Human Research Committee Alpha approved on the 25th November 2008 (ref: 08AL 332)
Study design
Randomised controlled trial
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Other
Trial type
Treatment
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
Condition
Depression, anxiety
Intervention
1. CBT plus treatment as usual: Participants will receive up to 16 one-to-one manualised cognitive behavioural therapy treatment sessions over a period of 16 weeks (4 months) in addition to the usual service they receive from the intellectual disability service.
2. Treatment as usual (TAU): This is the standard treatment which would be available to any adult with an intellectual disability referred to the intellectual disability service. This includes care management, medical, non specific psychological input, nursing or social support.
Screening:
Potential participants will be screened for anxiety and/or depression using the Mini PAS-ADD (Psychiatric Assessment Schedules for Adults with Developmental Disabilities; Moss, 2002). Those identified as cases (greater than 10 for depression and greater than 7 for anxiety) will be eligible for the study. The range of scores indicating severity is between 11 - 32 for depression and 7 - 18 for anxiety.
Intervention type
Other
Phase
Not Applicable
Drug names
Primary outcome measure
Participants will be assessed to measure the severity of their cognitive aspects of anxiety and/or depression using two subscales of the Beck Youth Inventories (BYI). These will be Beck Anxiety Inventory Youth (BAI-Y) and Beck Depression Inventory Youth (BDI-Y). Both sub-scales will be administered at baseline, end of treatment (i.e. four months) and at follow-up (i.e. six months).
Secondary outcome measures
1. Costs will be measured by administration of the Client Service Receipt Inventory, intellectual disability version (CSRI-ID version) at baseline and end of treatment (i.e. four months)
2. A quality of life questionnaire (Manchester Short Assessment of Quality of Life) that consists of 16-items. Each item is rated on a seven-point satisfaction scale, from 1 = 'Couldn't be worse' to 7 = 'Couldnt be better'. It will be administered at baseline and at the end of treatment (i.e. four months).
3. Satisfaction with treatment will be measured by using a modified client satisfaction questionnaire which will elicit the client's perception of the mental health service/intervention at baseline and end of treatment (i.e. four months)
4. There will also be an open question with prompts about the experience and process of therapy to both service users and their carers to gain a better understanding of how the intervention was perceived and valued
Overall trial start date
01/03/2010
Overall trial end date
31/08/2011
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Adults aged 16 years and over (either sex) who have mild intellectual disability (as determined on the service register)
2. A disorder with one of the following International Classification of Diseases, version 10 (ICD-10) codes: F32, F33, F34, F38, F40, F41 (anxiety, depression or mixed affective states)
3. Only participants with English as their main/spoken language
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
30
Participant exclusion criteria
1. Participants with co-morbid conditions of substance misuse, autism and those already receiving psychological treatment
2. Service users with moderate/severe intellectual disability
Recruitment start date
01/03/2010
Recruitment end date
31/08/2011
Locations
Countries of recruitment
United Kingdom
Trial participating centre
University College London
London
W1W 7EJ
United Kingdom
Sponsor information
Organisation
Camden and Islington Mental Health and Social Care Trust (UK)
Sponsor details
Research and Development Office
West Wing
St Pancras Hospital
4 St Pancras Way
London
NW1 0PE
United Kingdom
+44 (0)20 3317 3763
lynis.lewis@camdenpct.nhs.uk
Sponsor type
Hospital/treatment centre
Website
Funders
Funder type
Government
Funder name
National Institute for Health Research
Alternative name(s)
NIHR
Funding Body Type
government organisation
Funding Body Subtype
National government
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
1. 2011 protocol in http://www.ncbi.nlm.nih.gov/pubmed/21492437
2. 2013 results in http://www.ncbi.nlm.nih.gov/pubmed/23827533
Publication citations
-
Protocol
Hassiotis A, Serfaty M, Azam K, Strydom A, Martin S, Parkes C, Blizard R, King M, Cognitive behaviour therapy (CBT) for anxiety and depression in adults with mild intellectual disabilities (ID): a pilot randomised controlled trial., Trials, 2011, 12, 95, doi: 10.1186/1745-6215-12-95.