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Mental health
Research
Computerised cognitive–behavioural therapy for depression in adolescents: feasibility results and 4-month outcomes of a UK randomised controlled trial
  1. Barry Wright1,
  2. Lucy Tindall2,
  3. Elizabeth Littlewood3,
  4. Victoria Allgar3,
  5. Paul Abeles4,
  6. Dominic Trépel3,
  7. Shehzad Ali3
  1. 1University of York (Child Oriented Mental health Intervention Centre – COMIC), Adolescent and Family Unit, York, UK
  2. 2Leeds and York Partnership NHS Foundation Trust (Child Oriented Mental health Intervention Centre – COMIC), York, UK
  3. 3The University of York, York, UK
  4. 4Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  1. Correspondence to Professor Barry Wright; barry.wright1{at}nhs.net

Abstract

Objectives Computer-administered cognitive–behavioural therapy (CCBT) may be a promising treatment for adolescents with depression, particularly due to its increased availability and accessibility. The feasibility of delivering a randomised controlled trial (RCT) comparing a CCBT program (Stressbusters) with an attention control (self-help websites) for adolescent depression was evaluated.

Design Single centre RCT feasibility study.

Setting The trial was run within community and clinical settings in York, UK.

Participants Adolescents (aged 12–18) with low mood/depression were assessed for eligibility, 91 of whom met the inclusion criteria and were consented and randomised to Stressbusters (n=45) or websites (n=46) using remote computerised single allocation. Those with comorbid physical illness were included but those with psychosis, active suicidality or postnatal depression were not.

Interventions An eight-session CCBT program (Stressbusters) designed for use with adolescents with low mood/depression was compared with an attention control (accessing low mood self-help websites).

Primary and secondary outcome measures Participants completed mood and quality of life measures and a service Use Questionnaire throughout completion of the trial and 4 months post intervention. Measures included the Beck Depression Inventory (BDI) (primary outcome measure), Mood and Feelings Questionnaire (MFQ), Spence Children's Anxiety Scale (SCAS), the EuroQol five dimensions questionnaire (youth) (EQ-5D-Y) and Health Utility Index Mark 2 (HUI-2). Changes in self-reported measures and completion rates were assessed by treatment group.

Results From baseline to 4 months post intervention, BDI scores and MFQ scores decreased for the Stressbusters group but increased in the website group. Quality of life, as measured by the EQ-5D-Y, increased for both groups while costs at 4 months were similar to baseline. Good feasibility outcomes were found, suggesting the trial process to be feasible and acceptable for adolescents with depression.

Conclusions With modifications, a fully powered RCT is achievable to investigate a promising treatment for adolescent depression in a climate where child mental health service resources are limited.

Trial registration number ISRCTN31219579.

  • Randomised Controlled Trial
  • computerised Cognitive Behaviour Therapy
  • Depression
  • Adolescents

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-012834

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    Footnotes

    • Contributors BW was responsible for the overall development of an ethically sound protocol. BW and EL were involved in the conception and production of the study and the development of the initial protocol. PA was one of the developers of the Stressbusters CCBT program and provided advice and support throughout the study. VA provided statistical expertise while SA and DT advised on the design and conduct of the health economic analysis. LT assisted with the day-to-day running of the trial. All authors made substantial contributions to the drafting, critical revision and final approval of the paper.

    • Funding This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (grant reference number PB-PG-0609-19 295).

    • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

    • Competing interests None declared.

    • Ethics approval The trial was designed to protect the human rights and dignity of the participant as reflected in the 1996 version of the Helsinki Declaration. Ethical approval for this trial was received from Leeds (West) Research and Ethics Committee (Reference: 10/H1307/137).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Trial Sponsor Leeds and York Partnership NHS Foundation Trust, North Wing, St Mary's House, St Martin's View, Leeds, LS7 3JX.