title: A parallel group randomised open blinded evaluation of Acceptance and Commitment Therapy for depression after psychosis: Pilot trial outcomes (ADAPT).
abstract: 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.
  
  
  
  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).
  
  
  
  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).
  
  
  
  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.
  
  
  
  ISRCTN: 33306437.
authors.affiliation: Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, United Kingdom. Electronic address: andrew.gumley@glasgow.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gumley
authors.affiliation: Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, United Kingdom; Institute of Psychology, Health and Society, University of Liverpool, United Kingdom.
authors.forename: Ross
authors.initials: R
authors.lastname: White
authors.affiliation: Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Andy
authors.initials: A
authors.lastname: Briggs
authors.affiliation: Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Ford
authors.affiliation: Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Barry
authors.affiliation: Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Corinna
authors.initials: C
authors.lastname: Stewart
authors.affiliation: Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Sara
authors.initials: S
authors.lastname: Beedie
authors.affiliation: NHS Greater Glasgow & Clyde, United Kingdom.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: McTaggart
authors.affiliation: Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Caoimhe
authors.initials: C
authors.lastname: Clarke
authors.affiliation: NHS Greater Glasgow & Clyde, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: MacLeod
authors.affiliation: NHS Greater Glasgow & Clyde, United Kingdom.
authors.forename: Emma
authors.initials: E
authors.lastname: Lidstone
authors.affiliation: Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Bruno Salgado
authors.initials: BS
authors.lastname: Riveros
authors.affiliation: Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Robin
authors.initials: R
authors.lastname: Young
authors.affiliation: Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
authors.forename: Hamish
authors.initials: H
authors.lastname: McLeod
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy / Q000209:etiology* / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents
keywords: Acceptance and Commitment Therapy; Depression; Pilot; Randomised controlled trial; Schizophrenia