CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacy
Background People at high risk for psychosis access primary care mental health services for depression and anxiety and are unlikely to recover from these affective symptoms. We report the first controlled trial of cognitive–behavioural therapy (CBT) for depression and anxiety, minimally adapted fo...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-05-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472425000274/type/journal_article |
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| author | Katherine Newman-Taylor Tess Maguire Tanya Smart Emma Bayford Emily Gosden Grace Addyman Jessica Grange Pete Bullard Miriam Simmons-Dauvin Morad Margoum Ben Smart Keith Das Sophie Hardy Catherine Hiscutt Charlotte Hodges Adam Holleyman Hettie Jones Kate Spurr Jessica Trickett Elizabeth Graves |
| author_facet | Katherine Newman-Taylor Tess Maguire Tanya Smart Emma Bayford Emily Gosden Grace Addyman Jessica Grange Pete Bullard Miriam Simmons-Dauvin Morad Margoum Ben Smart Keith Das Sophie Hardy Catherine Hiscutt Charlotte Hodges Adam Holleyman Hettie Jones Kate Spurr Jessica Trickett Elizabeth Graves |
| author_sort | Katherine Newman-Taylor |
| collection | DOAJ |
| description |
Background
People at high risk for psychosis access primary care mental health services for depression and anxiety and are unlikely to recover from these affective symptoms. We report the first controlled trial of cognitive–behavioural therapy (CBT) for depression and anxiety, minimally adapted for psychosis risk, in primary care.
Aims
To evaluate feasibility, acceptability and signals of efficacy for CBT for depression and anxiety adapted for psychosis risk, designed in collaboration with people with psychosis.
Method
A longitudinal controlled trial comparing best practice CBT for depression and anxiety (CBT-BP) with CBT adapted for psychosis risk (CBT-PR), in patients meeting criteria for UK primary care services and who are also clinically high risk for psychosis (trial registration no. ISRCTN40678).
Results
Rates of recruitment (55 to CBT-BP, 44 to CBT-PR), completion of measures (90% CBT-BP, 94% CBT-PR) and retention in therapy (75% CBT-BP, 95% CBT-PR) demonstrate the feasibility and acceptability of the adapted therapy. Routine measures of depression and anxiety signal improved clinical and recovery outcomes for CBT-PR. Psychosis and relational measures signal sustained improvement (at 3 months) in the CBT-PR group. No serious adverse events were reported.
Conclusions
Primary care mental health services present a unique opportunity to identify and treat people at risk of psychosis at a time when they are help-seeking. CBT for depression and anxiety, minimally adapted for psychosis risk, can be delivered in routine services, and is likely to improve clinical and recovery outcomes and reduce psychosis risk. A definitive trial is needed to estimate clinical and cost-effectiveness.
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| format | Article |
| id | doaj-art-555e554acd424dfdba5decc67606de88 |
| institution | OA Journals |
| issn | 2056-4724 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-555e554acd424dfdba5decc67606de882025-08-20T01:50:07ZengCambridge University PressBJPsych Open2056-47242025-05-011110.1192/bjo.2025.27CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacyKatherine Newman-Taylor0https://orcid.org/0000-0003-1579-7959Tess Maguire1Tanya Smart2Emma Bayford3Emily Gosden4Grace Addyman5Jessica Grange6Pete Bullard7Miriam Simmons-Dauvin8Morad Margoum9Ben Smart10Keith Das11Sophie Hardy12Catherine Hiscutt13Charlotte Hodges14Adam Holleyman15Hettie Jones16Kate Spurr17Jessica Trickett18Elizabeth Graves19School of Psychology, University of Southampton, Southampton, UK Psychology, Southern Health NHS Foundation Trust, Southampton, UKSchool of Psychology, University of Southampton, Southampton, UK Psychology, Southern Health NHS Foundation Trust, Southampton, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKTalking Therapies, Isle of Wight NHS Trust, Newport, UKTalking Therapies, Isle of Wight NHS Trust, Newport, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKTalking Therapies, Isle of Wight NHS Trust, Newport, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKTalking Therapies, Dorset HealthCare University NHS Foundation Trust, Bournemouth, UKTalking Therapies, Dorset HealthCare University NHS Foundation Trust, Bournemouth, UKTalking Therapies, Dorset HealthCare University NHS Foundation Trust, Bournemouth, UKTalking Therapies, Dorset HealthCare University NHS Foundation Trust, Bournemouth, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKTalking Therapies, Isle of Wight NHS Trust, Newport, UKTalking Therapies, Dorset HealthCare University NHS Foundation Trust, Bournemouth, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKTalking Therapies, Solent NHS Trust, Portsmouth, UKSchool of Psychology, University of Southampton, Southampton, UK Background People at high risk for psychosis access primary care mental health services for depression and anxiety and are unlikely to recover from these affective symptoms. We report the first controlled trial of cognitive–behavioural therapy (CBT) for depression and anxiety, minimally adapted for psychosis risk, in primary care. Aims To evaluate feasibility, acceptability and signals of efficacy for CBT for depression and anxiety adapted for psychosis risk, designed in collaboration with people with psychosis. Method A longitudinal controlled trial comparing best practice CBT for depression and anxiety (CBT-BP) with CBT adapted for psychosis risk (CBT-PR), in patients meeting criteria for UK primary care services and who are also clinically high risk for psychosis (trial registration no. ISRCTN40678). Results Rates of recruitment (55 to CBT-BP, 44 to CBT-PR), completion of measures (90% CBT-BP, 94% CBT-PR) and retention in therapy (75% CBT-BP, 95% CBT-PR) demonstrate the feasibility and acceptability of the adapted therapy. Routine measures of depression and anxiety signal improved clinical and recovery outcomes for CBT-PR. Psychosis and relational measures signal sustained improvement (at 3 months) in the CBT-PR group. No serious adverse events were reported. Conclusions Primary care mental health services present a unique opportunity to identify and treat people at risk of psychosis at a time when they are help-seeking. CBT for depression and anxiety, minimally adapted for psychosis risk, can be delivered in routine services, and is likely to improve clinical and recovery outcomes and reduce psychosis risk. A definitive trial is needed to estimate clinical and cost-effectiveness. https://www.cambridge.org/core/product/identifier/S2056472425000274/type/journal_articleCHR-PARMSearly interventionTalking Therapiesattachment |
| spellingShingle | Katherine Newman-Taylor Tess Maguire Tanya Smart Emma Bayford Emily Gosden Grace Addyman Jessica Grange Pete Bullard Miriam Simmons-Dauvin Morad Margoum Ben Smart Keith Das Sophie Hardy Catherine Hiscutt Charlotte Hodges Adam Holleyman Hettie Jones Kate Spurr Jessica Trickett Elizabeth Graves CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacy BJPsych Open CHR-P ARMS early intervention Talking Therapies attachment |
| title | CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacy |
| title_full | CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacy |
| title_fullStr | CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacy |
| title_full_unstemmed | CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacy |
| title_short | CBT for depression and anxiety adapted for psychosis risk in primary care: controlled trial to assess feasibility, acceptability and signals of efficacy |
| title_sort | cbt for depression and anxiety adapted for psychosis risk in primary care controlled trial to assess feasibility acceptability and signals of efficacy |
| topic | CHR-P ARMS early intervention Talking Therapies attachment |
| url | https://www.cambridge.org/core/product/identifier/S2056472425000274/type/journal_article |
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