A parallel group randomised open blinded evaluation of A cceptance and Commitment Therapy for d epression a fter p sychosis: Pilot t rial outcomes (ADAPT)
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.
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TL;DR
In this pilot PROBE RCT of Acceptance and Commitment Therapy for depression after psychosis (ACTdp+SC vs SC alone), 29 participants with schizophrenia and major depression were randomized. ACTdp+SC showed a significant self-reported depression (BDI) effect at 5 months but not 10 months, with no significant CDSS effect at either follow-up.
Key findings
- A total of 29 participants were randomized to ACTdp+SC (n=15) or SC alone (n=14). CDSS total score showed no significant between-group differences at 5 months (Coeff=-1.43, 95%CI -5.17,2.32, p=0.45) or 10 months (Coeff=1.8, 95%CI -2.10,5.69, p=0.36).
- BDI showed 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). In per-protocol analyses, BDI effects were sustained at 5 months (Coeff=-10.18, 95%CI -17.69,-2.68, p=0.01) and 10 months (Coeff=-8.11, 95%CI -15.62,-0.60, p=0.04).
- Psychological flexibility (AAQ) improved significantly in favour of ACTdp+SC at 5 months (Coeff=-0.883, 95%CI -14.94,-2.71, p<0.01) but not at 10 months (Coeff=-4.92, 95%CI -11.09,1.25, p=0.11). KIMS Observing and KIMS Total showed significant 10-month effects in ITT analyses.
- Intervention engagement: on average 17.4 (s.d.=5.9) ACTdp sessions were scheduled and 15.4 (s.d.=6.2) attended; 10 participants (71.4%) attended 10 or more sessions. There were 7 Serious Adverse Events (2 in ACTdp+SC, 5 in SC) and 14 unblindings (11 in ACTdp+SC, 3 in SC); 25 participants (86.3%) were retained in follow-up over 10 months.
Methods
- Design: parallel group Randomised Open Blinded Evaluation (PROBE) pilot trial of ACTdp+SC versus SC alone, registered as ISRCTN 33306437, with blinded follow-ups at 5 months (end of treatment) and 10 months (5 months post-treatment).
- Participants: consecutively recruited inpatients or outpatients aged 16 or over receiving antipsychotic medication and secondary mental health follow-up, meeting DSM-IV-TR criteria for schizophrenia and major depression (confirmed by SCID-I and CDSS score >7). Randomization was individual-level and stratified for early (<2 years) versus established (>2 years) psychosis.
- Outcomes and analysis: primary outcomes were CDSS and BDI; therapy mechanisms were KIMS and AAQ-II; secondary outcomes included PANSS and QPR. Exploratory repeated measures regression models adjusted for baseline measures including the stratification variable, with both ITT and per-protocol sample analyses reported.
Limitations
- Stated: the sample size of 29 was small, and the trial was not powered or designed as an efficacy or effectiveness trial.
- Stated: rates of unblinding were high in the ACTdp+SC group; the source of unblindings was participants and less frequently health service staff, though mitigations included alternative blinded assessors and audio-recorded assessments.
- Evident from the text: the sample was predominantly male (n=19, 65.5%), white Scottish (n=27, 93.1%), mean age 46.5 years, and recruited in one NHS Greater Glasgow & Clyde setting, with follow-up limited to 10 months; these features limit generalizability. The lack of CDSS signal alongside a positive BDI signal also suggests possible observer-rated versus self-reported measurement discrepancy.
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- Findingown data§ Abstract: · p. 3
There were no significant differences between groups on the CDSS total score at 5-months (Coeff=-1.43, 95%CI -5.17,2.32, p=0.45).
“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)”
- Also stated in: § Outcomes · p. 9 · plain
“We did not observe significant differences between groups on the CDSS total score at 5months (Coeff=-1.43, 95%CI -5.17,2.32, p=0.45)”
Quote in the paperNot a substantial claim - Also stated in: § Outcomes · p. 9 · plain
- Findingown data§ Abstract: · p. 3
There were no significant differences between groups on the CDSS total score at 10-months (Coeff=1.8, 95%CI -2.10, 5.69, p=0.36).
“or at 10months (Coeff=1.8, 95%CI -2.10, 5.69, p=0.36).”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 3 about here · p. 10
There was no significant effect in favour of ACTdp+SC on psychological flexibility at 10-months (Coeff=-4.92, 95%CI -11.09, 1.25, p=0.11).
“but not at 10-months (Coeff=-4.92, 95%CI -11.09, 1.25, p=0.11).”
Quote in the paperSubstantial claim - Findingown data§ Abstract: · p. 3
There was no statistically significant effect in favour of ACTdp+SC on the BDI at 10-months (Coeff=-4.85, 95%CI -12.10, 2.39, p=0.18).
“but not at 10-months (Coeff=-4.85, 95%CI -12.10, 2.39, p=0.18).”
Quote in the paperSubstantial claim - Findingown data§ Outcomes · p. 9
There was a statistically significant effect in favour of ACTdp+SC on the BDI at 5-months (Coeff=-8.38, 95%CI -15.49, -1.27, p=0.02).
“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)”
Quote in the paperSubstantial claim
- Findingown data§ Abstract: · p. 3
29 participants were randomized to ACTdp+SC (n=15) or SC alone (n=14).
“A total of 29 participants were randomized to ACTdp + Standard Care (SC) (n=15) or SC alone (n=14).”
- Also stated in: § Population · p. 9 · plain
“This left 29 participants who were fully assessed before being randomized to ACTdp+SC (n=15) or SC alone (n=14).”
Quote in the paperSubstantial claim - Also stated in: § Population · p. 9 · plain
- Findingown data§ Insert Table 1 about here · p. 9
All SAEs were related to hospitalization.
“All SAEs were related to Hospitalization”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 1 about here · p. 9
During the trial, 7 Serious Adverse Events (SAEs) were observed.
“During the trial we observed 7 Serious Adverse Events (SAEs).”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 3 about here · p. 10
In the PPS analysis, significant effects in favour of ACTdp+SC were noted for KIMS Total at 10-months (Coeff=12.63, 95%CI 3.25, 22.00, p=0.01).
“and 10-months (Coeff=12.63, 95%CI 3.25, 22.00, p=0.01).”
Quote in the paperNot a substantial claim - Findingown data§ Intervention · p. 9
On average 15.4 (s.d.=6.2) ACTdp sessions were attended by participants.
“and 15.4 (s.d.=6.2) were attended by participants.”
Quote in the paperNot a substantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with psychological flexibility change at 10 months (r=0.41, p<0.05).
“With respect to changes in BDI we observed significant correlations with changes in psychological flexibility at 5-months (r=0.55,p<0.01) and 10-months (r=0.41,p<0.05).”
Quote in the paperSubstantial claim - Findingown data§ Secondary Outcomes · p. 10
We did not observe any other effects on outcomes using the Questionnaire for Personal Recovery and the Positive and Negative Syndrome Scale with one exception.
“We did not observe any other effects on outcomes using the Questionnaire for Personal Recovery and the Positive and Negative Syndrome Scale with one exception”
Quote in the paperNot a substantial claim - Findingreasoning§ Mechanisms of Change · p. 10
No significant associations were observed between CDSS depression change and hypothesized mechanisms of change at either 5 or 10 months.
“Consistent with the lack of observed effects on CDSS we observed no significant associations between depression and hypothesized mechanisms of change at either 5 or 10-months.”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 3 about here · p. 10
At 10-months, significant outcomes in favour of ACTdp+SC were noted for KIMS Observing (Coeff=4.94, 95%CI 0.47, 9.41, p=0.03).
“At 10months significant outcomes in favour of ACTdp+SC were noted for KIMS Observing (Coeff=4.94, 95%CI 0.47, 9.41, p=0.03)”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 3 about here · p. 10
In the PPS analysis, significant effects in favour of ACTdp+SC were noted for KIMS Accepting at 10-months (Coeff=5.39, 95%CI 1.29, 9.40, p=0.01).
“and 10months (Coeff=5.39, 95%CI 1.29, 9.40, p=0.01)”
Quote in the paperNot a substantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with KIMS Observing change at 5 months (r=-0.58, p<0.01).
“Furthermore, we observed significant associations between KIMS Observing (r=-0.58,p<0.01), KIMS Describing (r=0.63,p<0.01), KIMS Awareness (r=-0.41,p<0.01) and change in BDI at 5-months.”
Quote in the paperNot a substantial claim - Findingown data§ Secondary Outcomes · p. 10
In the PPS analyses, significant effects in favour of ACTdp+SC were noted for PANSS Cognitive Disorganisation at 5-months (Coeff=-6.16, 95%CI -15.49, 1.27, p=0.003).
“PANSS Cognitive Disorganisation (Coeff=-6.16, 95%CI -15.49, 1.27, p=0.003)”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 3 about here · p. 10
In the PPS analysis, AAQ outcomes at 5-months were significant (Coeff=-10.71, 95%CI -16.16, -5.26, p=0.0004).
“In the PPS analysis outcomes at 5-months (Coeff=-10.71, 95%CI -16.16, -5.26, p=0.0004)”
Quote in the paperSubstantial claim - Findingown data§ Secondary Outcomes · p. 10
There was a significant effect in favour of ACTdp+SC on PANSS Cognitive Disorganisation at 5-months (Coeff=-4.92, 95%CI -8.50, -1.35, p=0.01).
“there was a significant effect in favour of ACTdp+SC on PANSS Cognitive Disorganisation (Coeff=-4.92, 95%CI -8.50, -1.35, p=0.01)”
Quote in the paperNot a substantial claim - Findingown data§ Secondary Outcomes · p. 10
There was a significant effect in favour of ACTdp+SC on PANSS Excitement at 5-months (Coeff=1.98, 95%CI -3.60, -0.35, p=0.019).
“and PANSS Excitement at 5months (Coeff=1.98, 95%CI -3.60, -0.35, p=0.019).”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 3 about here · p. 10
In the PPS analysis, significant effects in favour of ACTdp+SC were noted for KIMS Accepting at 5-months (Coeff=4.78, 95%CI 0.68, 8.88, p=0.02).
“In the PPS analysis significant effects in favour of ACTdp+SC were noted for KIMS Accepting at 5-months (Coeff=4.78, 95%CI 0.68, 8.88, p=0.02)”
Quote in the paperNot a substantial claim - Findingown data§ Secondary Outcomes · p. 10
In the PPS analyses, significant effects in favour of ACTdp+SC were noted for PANSS Total at 5-months (Coeff=-12.45, 95%CI -23.11, -1.80, p=0.02).
“and PANSS Total (Coeff=-12.45, 95%CI -23.11, -1.80, p=0.02) at 5-months.”
Quote in the paperNot a substantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with psychological flexibility change at 5 months (r=0.55, p<0.01).
“With respect to changes in BDI we observed significant correlations with changes in psychological flexibility at 5-months (r=0.55,p<0.01) and 10-months (r=0.41,p<0.05).”
Quote in the paperSubstantial claim - Findingown data§ Outcomes · p. 9
In the PPS analyses, BDI outcomes favoured ACTdp+SC at 5-months (Coeff=-10.18, 95%CI 17.69, -2.68, p=0.01).
“In the PPS analyses we noted sustained outcomes in favour of ACTdp+SC at both 5-months (Coeff=-10.18, 95%CI 17.69, -2.68, p=0.01)”
Quote in the paperSubstantial claim - Findingown data§ Insert Table 3 about here · p. 10
In the PPS analysis, significant effects in favour of ACTdp+SC were noted for KIMS Total at 5-months (Coeff=9.44, 95%CI 0.07, 18.82, p=0.05).
“and KIMS Total at 5-months (Coeff=9.44, 95%CI 0.07, 18.82, p=0.05)”
Quote in the paperNot a substantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with KIMS Describing change at 5 months (r=0.63, p<0.01).
“Furthermore, we observed significant associations between KIMS Observing (r=-0.58,p<0.01), KIMS Describing (r=0.63,p<0.01), KIMS Awareness (r=-0.41,p<0.01) and change in BDI at 5-months.”
Quote in the paperNot a substantial claim - Findingown data§ Intervention · p. 9
The number of participants attending 10 or more sessions was 10 (71.4%).
“The number of participants attending 10 or more sessions (our a priori definition of an adequate number of sessions) was 10 (71.4%).”
Quote in the paperNot a substantial claim - Findingown data§ Secondary Outcomes · p. 10
In the PPS analyses, significant effects in favour of ACTdp+SC were noted for PANSS Emotional Distress at 5-months (Coeff=-2.46, 95%CI -4.74, -0.18, p=0.04).
“PANSS Emotional Distress (Coeff=-2.46, 95%CI -4.74, -0.18, p=0.04)”
Quote in the paperNot a substantial claim - Findingown data§ Insert Table 3 about here · p. 10
At 10-months, significant outcomes in favour of ACTdp+SC were noted for KIMS Total (Coeff=10.91, 95%CI 0.22, 21.60, p=0.05).
“and KIMS Total (Coeff=10.91, 95%CI 0.22, 21.60, p=0.05).”
Quote in the paperNot a substantial claim - Findingown data§ Outcomes · p. 9
In the PPS analyses, BDI outcomes favoured ACTdp+SC at 10-months (Coeff=-8.11, 95%CI -15.62, -0.60, p=0.04).
“and 10-months (Coeff=-8.11, 95%CI -15.62, -0.60, p=0.04).”
Quote in the paperSubstantial claim - Findingown data§ Discussion: · p. 12
No change signals were observed on the CDSS.
“We did not observe any change signals on the CDSS.”
Quote in the paperNot a substantial claim - Findingown data§ Discussion: · p. 12
There was a statistically significant improvement in BDI-II for the ACTdp+SC group at 5 months.
“We noted a statistically significant improvement in BDI-II for the ACTdp+SC group at 5-months”
Quote in the paperSubstantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with KIMS Acceptance change at 10 months (r=-0.49, p<0.01).
“Finally we observed as significant association between KIMS Describing (r=0.49,p<0.01), KIMS Awareness (r=-0.53,p<0.01), KIMS Acceptance (r=-0.49,p<0.01) and change in BDI at 10-months.”
Quote in the paperSubstantial claim - Findingnone given§ Discussion: · p. 11
Potential participants rarely reported depressed mood despite severe symptoms on the BDI-II.
“potential participants rarely reported depressed mood (despite severe symptoms on the BDI-II)”
Quote in the paperSubstantial claim - Findingown data§ Discussion: · p. 12
Our study showed no signal on any observer-based measures.
“lack of any signal on any observer based measures in our study is an important consideration.”
Quote in the paperSubstantial claim - Findingown data§ Discussion: · p. 11
Over 10 months, 25 (86.3%) of participants were retained in follow-up.
“Over 10-months we retained 25 (86.3%) of participants in follow-up.”
Quote in the paperNot a substantial claim - Findingown data§ Discussion: · p. 12
Statistically significant changes in psychological flexibility and mindfulness were observed.
“we observed statistically significant changes in psychological flexibility and mindfulness.”
Quote in the paperSubstantial claim - Findingown data§ Discussion: · p. 11
70% of participants received at least 10 sessions of therapy.
“70% received at least 10-sessions of therapy.”
Quote in the paperNot a substantial claim - Findingown data§ Discussion: · p. 11
On average participants received 15 sessions over 5 months.
“On average participants received 15 sessions over 5-months”
Quote in the paperNot a substantial claim - Findingown data§ Discussion: · p. 12
There was no statistically significant improvement in BDI-II for the ACTdp+SC group at 10 months.
“but not at 10-months.”
Quote in the paperSubstantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with KIMS Describing change at 10 months (r=0.49, p<0.01).
“Finally we observed as significant association between KIMS Describing (r=0.49,p<0.01), KIMS Awareness (r=-0.53,p<0.01), KIMS Acceptance (r=-0.49,p<0.01) and change in BDI at 10-months.”
Quote in the paperNot a substantial claim - Findingown data§ Discussion: · p. 12
Between-group Cohen's effect size was r=0.31 at 10 months.
“and r=0.31 at 10-months.”
Quote in the paperSubstantial claim - Findingown data§ Discussion: · p. 12
Between-group Cohen's effect size was r=0.67 at 5 months end of treatment.
“We noted a between group Cohen's Effect Size of r=0.67 at 5-months end of treatment”
Quote in the paperSubstantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with KIMS Awareness change at 10 months (r=-0.53, p<0.01).
“Finally we observed as significant association between KIMS Describing (r=0.49,p<0.01), KIMS Awareness (r=-0.53,p<0.01), KIMS Acceptance (r=-0.49,p<0.01) and change in BDI at 10-months.”
Quote in the paperSubstantial claim - Findingown data§ Mechanisms of Change · p. 10
BDI change correlated with KIMS Awareness change at 5 months (r=-0.41, p<0.01).
“Furthermore, we observed significant associations between KIMS Observing (r=-0.58,p<0.01), KIMS Describing (r=0.63,p<0.01), KIMS Awareness (r=-0.41,p<0.01) and change in BDI at 5-months.”
Quote in the paperNot a substantial claim - Premisecitation§ Background · p. 4
There is a lack of robust evidence supporting the use of antidepressant interventions for depression in the context of schizophrenia.
“There is a lack of robust evidence supporting the use of antidepressant (Whitehead et al., 2002)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Whitehead et al., 2002 source
Not checked in the free run.
- Premisecitation§ Background · p. 4
Shame is a key feature in the emergence of depression in individuals with psychosis and schizophrenia.
“Shame is key feature in the emergence of depression (Gumley, Braehler, Laithwaite, Macbeth, Gilbert, 2010)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gumley, Braehler, Laithwaite, Macbeth, Gilbert, 2010
Not checked in the free run.
- Premisecitation§ Background · p. 4
Depression contributes to poorer quality of life amongst individuals with psychosis and schizophrenia.
“Depression contributes to poorer quality of life amongst individuals with psychosis and schizophrenia (Saarni et al., 2010).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Saarni et al., 2010 source
Not checked in the free run.
- Interpretationown data§ Abstract: · p. 3
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.
“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.”
Quote in the paperSubstantial claim- Rests on an assumption: This is the first RCT of a psychological therapy with depression as the primary outcome in psychosis.
- Study design and conductown data§ Primary Outcomes : · p. 7
In this study the Intraclass Correlation Coefficient for the CDSS was ICC=0.68 (95%CI, 0.46-0.82).
“In this study the Intraclass Correlation Coefficient was ICC=0.68 (95%CI, 0.46-0.82).”
Quote in the paperNot a substantial claim - Premisecitation§ Background · p. 4
Depression is not typically assessed in CBTp trials.
“this important outcome domain is not typically assessed in CBTp trials (Jauhar et al., 2014)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Jauhar et al., 2014 source
Not checked in the free run.
- Premisecitation§ Background · p. 4
There is preliminary evidence that depression symptoms improve in people receiving CBT for psychosis (CBTp).
“Although there is preliminary evidence that depression symptoms improve in people receiving CBT for psychosis (CBTp)(Wykes et al., 2008)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wykes et al., 2008 source
Not checked in the free run.
- Study design and conductown data§ Primary Outcomes : · p. 7
Inter-rater reliability for the CDSS was 92% (range 67-100%).
“Inter-rater reliability for the CDSS was 92% (range 67-100%).”
Quote in the paperNot a substantial claim - Premisecitation§ Primary Outcomes : · p. 7
The CDSS was better than the BDI, PANSS Depression subscale, and HAM-D for both sensitivity (94%) and specificity (89%) of SCID Depression diagnosis.
“The CDSS was better the BDI, PANSS Depression subscale, and HAM-D for both sensitivity (94%) and specificity (89%) of SCID Depression diagnosis (Kim et al., 2006).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Kim et al., 2006 source
Not checked in the free run.
- Interpretationown data§ Discussion: · p. 11
The ACTdp intervention was well tolerated.
“The ACTdp intervention was well tolerated.”
Quote in the paperNot a substantial claim - Premisecitation§ Discussion: · p. 12
A recent meta-analysis found a small non-significant between-group effect size (d=.26, n.s.) for ACT versus active control conditions.
“For ACT versus active control conditions (n=15 studies comprising n=755 participants) findings suggested a small non-significant between groups effect size (d=.26, n.s.)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Hacker, Stone & Macbeth, 2015, In Press
Not checked in the free run.
- Interpretationown data§ Discussion: · p. 12
The strongest signals in relation to ACTdp relate to measures of self-reported depression, psychological flexibility and mindfulness.
“we propose that the strongest signals in relation to ACTdp relate to measures of self reported depression, psychological flexibility and mindfulness.”
Quote in the paperSubstantial claim - Premisecitation§ Discussion: · p. 12
A recent meta-analysis found a large significant between-group effect size (d=.73, p<.001) for studies investigating ACT for depression as a primary treatment target.
“who found that studies investigating ACT for depression as a primary treatment target (n=12 studies comprising n=674 participants) suggested also large significant between group effect size (d= .73, p<.001).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hacker, Stone & Macbeth, 2015, In Press
Not checked in the free run.
- Interpretationreasoning§ Discussion: · p. 11
Identification and recruitment of potential participants was a key challenge for the study.
“One of the key challenges for the study was the identification and recruitment of potential participants.”
Quote in the paperNot a substantial claim- Rests on an assumption: Depression co-occurring with psychosis is not routinely identified by mental health staff.
- Rests on an assumption: Positive symptoms tend to be prioritised for monitoring and assessment over depression in this population.
- Rests on an assumption: There is poor discrimination between negative symptoms and depression.
- Rests on an assumption: Conversations about depressed mood and hopelessness are frequently avoided.
- Premisecitation§ Discussion: · p. 13
The 11 randomized controlled trials in Whitehead et al. (2002) Cochrane Review of antidepressants in schizophrenia all randomized n<30 participants.
“the 11 randomized controlled trials included in the Whitehead et al. (2002) Cochrane Review of antidepressants in schizophrenia all randomized n<30 participants.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Whitehead et al. (2002) source
Not checked in the free run.
- Study design and conductnone given§ Discussion: · p. 13
The sample size of 29 was small.
“First, the sample size of 29 was small.”
Quote in the paperSubstantial claim - Premisecitation§ Discussion: · p. 13
Gaudiano et al. (2015) found medium to large effects of ACT on depression and psychosocial functioning in people with affective psychoses.
“Gaudiano et al. (2015) conducted a randomized controlled trial of an ACT based treatment package for people with affective psychoses (mostly major depression with psychotic features) and found medium to large effects for of ACT on depression and psychosocial functioning.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gaudiano et al. (2015) source
Not checked in the free run.
- Study design and conductown data§ Discussion: · p. 13
The trial was blinded.
“although our trial was blinded”
Quote in the paperNot a substantial claim - Study design and conductnone given§ Discussion: · p. 13
The source of unblindings was participants and less frequently health service staff.
“the source of unblindings was participants and less frequently health service staff.”
Quote in the paperNot a substantial claim - Premisecitation§ Discussion: · p. 13
A clear signal emerging from the earlier trial was a change in depression amongst those participants receiving ACT.
“A clear signal emerging from the trial was a change in depression amongst those participants receiving ACT (White et al., 2013; White et al., 2015).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites White et al., 2013 source
Not checked in the free run.
- cites White et al., 2015
Not checked in the free run.
- Interpretationown data§ Discussion: · p. 13
ACT is a candidate treatment that has the potential to improve engagement with valued life goals and activities alongside feelings of depression and demoralization.
“ACT is one clear candidate treatment that has the potential to improve engagement with valued life goals and activities alongside feelings of depression and demoralization.”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 49
- May combine two claims. 18
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data§ Population · p. 9We identified 92 potential participants of whom 55 were referred to the study.
“We identified 92 potential participants of whom 55 were referred to the study.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Insert Figure 1 about here · p. 9The sample was 93.1% white Scottish (n=27).
“white Scottish (n=27, 93.1%)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Insert Figure 1 about here · p. 9The sample was 65.5% male (n=19).
“male (n=19, 65.5%)”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Insert Figure 1 about here · p. 9The sample had a mean of 13.2 years of education.
“with on average 13.2 years of education.”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown data§ Insert Table 1 about here · p. 92 (13.3%) SAEs were in the ACTdp+SC group and 5 (35.7%) were in the SC group.
“2 (13.3%) were in the ACTdp+SC group and 5 (35.7%) in the SC group.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data§ Population · p. 9Of the 55 referred, 38 gave their informed consent to enter the study and 7 were not eligible.
“Of this group, 38 gave their informed consent to enter the study and 7 were not eligible.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Insert Figure 1 about here · p. 9The sample had a mean age of 46.5 years.
“The sample were on average 46.5 years old”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Population · p. 9In the SC group, one participant declined follow-up at 10-months.
“In SC, 1 participant declined follow-up at 10-months.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Population · p. 9Two participants who initially gave their informed consent subsequently changed their mind before randomization.
“Two participants, who initially gave their informed consent subsequently changed their mind before randomization.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data§ Population · p. 9In the ACTdp+SC group, two participants declined follow-up at 5-months and one further participant was unable to be followed up at 10-months.
“In terms of follow-up of ACTdp+SC, two participants declined follow-up at 5-months and we were unable to follow-up 1 further participant at 10-months.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Insert Table 1 about here · p. 9There were 14 unblindings during the trial.
“There were 14 unblindings during the trial.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data§ Insert Table 1 about here · p. 9Of the 14 unblindings, 11 (73.3%) were in the ACTdp+SC group and 3 (21.4%) were in SC.
“Of these 11 (73.3%) were in the ACTdp+SC group and 3 (21.4%) were in SC.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown data§ Intervention · p. 9On average 17.4 (s.d.=5.9) ACTdp sessions were scheduled.
“On average 17.4 (s.d.=5.9) ACTdp sessions were scheduled”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown data§ Discussion: · p. 11Over 12 months, the study received 92 potential enquiries, 55 participant referrals, and 29 randomisations.
“Over a period of 12-months recruitment, we received 92 potential enquiries, converting to 55 participant referrals (referrals 4.6 per month) leading to 29 (2.4 per month) randomisations.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Background · p. 4Depression is associated with greater interpersonal problems in individuals with psychosis and schizophrenia.
“greater interpersonal problems (Rocca et al., 2005)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Rocca et al., 2005 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Background · p. 4Depression is associated with poorer adherence to treatment in individuals with psychosis and schizophrenia.
“poorer adherence to treatment (Conley, 2009)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Conley, 2009 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ Secondary Outcomes: · p. 7Inter-rater reliability for the PANSS in this trial was 83% (range 63 - 97%).
“Inter-rater reliability for the PANSS in this trial was 83% (range 63 - 97%).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Background · p. 4White et al. (2011) found a significant difference between the ACT and Treatment as Usual (TAU) groups for negative symptoms in people with psychosis.
“They found a significant difference between the ACT and Treatment as Usual (TAU) groups for negative symptoms.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites White et al., 2011 source
Not checked in the free run.
Classified as probably not a substantial claim.
Study design and conductnone given§ Follow-up: · p. 6Participants were assessed at entry pre-randomisation, 5 months and 10-months by a blinded RA.
“Participants were assessed at entry pre-randomisation, 5 months and 10-months by a blinded RA.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ Randomisation · p. 6Randomisation was organised at the Robertson Centre for Biostatistics, a fully registered and NIHR approved UK Clinical Trials Unit.
“Randomisation (at the individual level) was organised at the Robertson Centre for Biostatistics, a fully registered and NIHR approved UK Clinical Trials Unit.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Background · p. 4Gaudiano and Herbert (2006) found a small effect of ACT on negative emotion in people with psychosis.
“Gaudiano and Herbert (2006) found a small effect of ACT on negative emotion in people with psychosis.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gaudiano & Herbert, 2006 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Design: · p. 5The study protocol was registered before initiating recruitment (ISRCTN: 33306437).
“The study protocol was registered before initiating recruitment (ISRCTN: 33306437).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ Primary Outcomes : · p. 7In this study Cronbach's Alpha for the BDI was a =0.90.
“In this study Cronbach's Alpha was a =0.90.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Background · p. 4White et al. (2011) found a trend on the limit of significance for differences between the ACT and TAU groups in depression (p=0.051).
“There was also a trend on the limit of significance for differences between the groups in depression (p=0.051)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites White et al., 2011 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Background · p. 4White et al. (2011) found that improvement in depression was associated with self-reported increases in mindfulness.
“improvement in depression was associated with self-reported increases in mindfulness.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites White et al., 2011 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitation§ Design: · p. 5The protocol was published before treatment codes were broken and data were analysed.
“The protocol was published before treatment codes were broken and data were analysed (Gumley et al., 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gumley et al., 2015 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Background · p. 4White et al. (2015) found that ACT was associated with significantly greater likelihood of achieving a clinically significant improvement in depression.
“In a later analysis, White et al. (2015) found that ACT was associated with significantly greater likelihood of achieving a clinically significant improvement in depression.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites White et al., 2015
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Protecting the Blind: · p. 6Blinding was maintained using a wide range of measures (e.g. separate offices for therapists and researchers, protocols for answering phones, message taking and secretarial support, forbidding any discussions of participants between RAs and therapists following randomisation, separate diaries and security for electronic randomisation information).
“Blinding was maintained using a wide range of measures (e.g. separate offices for therapists and researchers, protocols for answering phones, message taking and secretarial support, forbidding any discussions of participants between RAs and therapists following randomisation, separate diaries and security for electronic randomisation information).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown data§ Entry: · p. 6Inter-rater reliability for the SCID-I was 90% (range 82-100%).
“Inter-rater reliability for the SCID-I was 90% (range 82-100%).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Secondary Outcomes: · p. 8The QPR has two subscales measuring intrapersonal tasks and interpersonal factors relevant to personal recovery and has excellent reliability and validity.
“The QPR has two subscales measuring intrapersonal tasks and interpersonal factors relevant to personal recovery and has excellent reliability and validity.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Neil et al., 2009 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ Inter-rater reliability: · p. 7Audio recordings were used for ongoing RA training, secondary assessment when blind breaks occurred, and fidelity checking to detect and correct rater drift.
“Audio recordings were used for ongoing RA training, secondary assessment when blind breaks occurred, and fidelity checking to detect and correct rater drift.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Therapy Mechanisms: · p. 7The AAQ-II has satisfactory structure, reliability, and validity.
“This measure has satisfactory structure, reliability, and validity.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Bond et al., 2011 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Inter-rater reliability: · p. 7RAs were trained in all of the study measures before commencing data collection.
“RAs were trained in all of the study measures before commencing data collection.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Therapy Mechanisms: · p. 7The KIMS has good internal consistency, test retest reliability and construct validity.
“The KIMS has good internal consistency, test retest reliability and construct validity.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Baer et al., 2004 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Acceptance and Commitment Therapy for depression after psychosis (ACTdp): · p. 8Fidelity of treatment strategy use and consistency with the ACT model were determined via weekly supervision by a senior clinician.
“Fidelity of treatment strategy use and consistency with the ACT model were determined via weekly supervision by a senior clinician.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ Insert Table 1 about here · p. 9All unblindings were rated by another Researcher masked to treatment allocation and subsequent follow-ups were blind rated.
“All unblindings were rated by another Researcher masked to treatment allocation and subsequent follow-ups were blind rated.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductnone given§ Discussion: · p. 12The study was not powered or designed as an efficacy or effectiveness trial.
“Although the study was not powered or designed as an efficacy or effectiveness trial”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion: · p. 12Lack of physical and leisure time activity is linked to poorer quality of life in schizophrenia.
“a lack of physical and leisure time activity is linked to poorer quality of life in schizophrenia (Vancampfort et al., 2011).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Vancampfort et al., 2011 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion: · p. 12In people with schizophrenia, higher rates of depression were associated with lower rates of physical activity and longer time spent in bed.
“Wichniak et al (2011) found that in people with schizophrenia, higher rates of depression were associated with lower rates of physical activity and longer time spent in bed.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wichniak et al (2011) source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Premisecitation§ Discussion: · p. 12In Fowler et al.'s trial of CBTsr, compared to TAU, CBTsr was associated with improved economic activity (increase of 4.4 hours versus 3.2 hours) and improved structured activity (12.0 hours versus 4.1 hours).
“The pilot study data showed signals suggesting that compared to TAU CBTsr was associated with improved economic activity (increase of 4.4 hours versus 3.2 hours) and improved structured activity (12.0 hours versus 4.1 hours).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Fowler et al. (2009) source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ Discussion: · p. 12The study had established a priori primary outcomes, therapy specific outcomes, and secondary outcomes.
“we had established a priori primary outcomes, therapy specific outcomes, and secondary outcomes.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion: · p. 13Depression has been associated with poorer interpersonal functioning.
“poorer interpersonal functioning (Rocca et al., 2005)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Rocca et al., 2005 source
Not checked in the free run.
Classified as probably not a substantial claim.
Premisecitation§ Discussion: · p. 13Depression is a major contributor to loss of quality of life in schizophrenia and other psychotic disorders.
“Depression is a major contributor to loss of quality of life in schizophrenia and other psychotic disorders (Saarni et al., 2010)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Saarni et al., 2010 source
Not checked in the free run.
May combine two claims.
Study design and conductown data§ Discussion: · p. 13Although the trial was blinded, rates of unblinding were high in the ACTdp+SC group.
“although our trial was blinded, our rates of unblinding were high in the ACTdp+SC group.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
Interpretationreasoning§ Discussion: · p. 13Taken together, these findings indicate a need for large scale, well-designed methodologically rigorous trials targeting depression in the context of psychosis.
“Taken together these findings indicate a need for large scale, well-designed methodologically rigorous trials targeting depression in the context of psychosis.”
Quote in the paperNot a substantial claimMay combine two claims.
Premisecitation§ Discussion: · p. 13Gaudiano et al. (2015) had a sample size of n=13, randomization was not independent of trial team, and assessment of outcome was unblinded.
“The study sample size was n=13, randomization was not independent of trial team and assessment of outcome was unblinded.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gaudiano et al. (2015) source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Discussion: · p. 13Where an unblinding occurred, an alternative blinded researcher was allocated to undertake subsequent follow-up assessments.
“Where an unblinding occurred we were able to allocate an alternative blinded researcher to undertake subsequent follow-up assessments.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion: · p. 13Depression has been associated with greater experiences of stigma.
“greater experiences of stigma (Angermeyer et al., 2004).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Angermeyer et al., 2004 source
Not checked in the free run.
May combine two claims.
Study design and conductown data§ Discussion: · p. 13All assessments were audio recorded (with consent), allowing unblinded assessments to be subjected to independent verification of symptom severity.
“since all assessments were audio recorded (with consent) we were able to subject unblinded assessments to independent verification of symptoms severity.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion: · p. 13Depression has been associated with longer duration of untreated psychosis.
“longer duration of untreated psychosis (Drake et al., 2003)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Drake et al., 2003 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion: · p. 13Depression has been associated with poorer adherence to treatment.
“Depression has been associated with poorer adherence to treatment (Conley, 2009)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Conley, 2009 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation§ Discussion: · p. 13Depression has been associated with greater problems in family relationships.
“greater problems in family relationships (Rocca et al., 2005)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Rocca et al., 2005 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ Discussion: · p. 13An independent randomization procedure protected the blind.
“an independent randomization procedure that protected the blind”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).
Interpretationreasoning§ Discussion: · p. 13The development of future large scale generalizable randomised controlled trials to improve depression and functioning in people with schizophrenia and other psychoses is clearly merited.
“The development of future large scale generalizable randomised controlled trials to improve depression and functioning in people with schizophrenia and other psychoses is clearly merited.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
The experience of psychosis can threaten progress in valued life domains.
“ACTdp is based on the rationale that the experience of psychosis can threaten progress in valued life domains.”
The paper relies on this without support.
ACT helps reduce unhelpful coping strategies including rumination and avoidance, and enables commitment to behavioural changes consistent with personal values.
“Acceptance and Commitment Therapy (ACT) could offer a promising psychological intervention that helps reduce unhelpful coping strategies including rumination and avoidance, and enables committment to behavioural changes consistent with personal values.”
The paper relies on this without support.
This is the first RCT of a psychological therapy with depression as the primary outcome in psychosis.
“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.”
The paper relies on this without support.
This is the first randomised controlled trial of any psychological therapy in psychosis that specified depression as a primary outcome.
“This is the first randomised controlled trial of any psychological therapy in psychosis that specified depression as a primary outcome.”
The paper relies on this without support.
Depression co-occurring with psychosis is not routinely identified by mental health staff.
“Depression co-occurring with psychosis was not routinely identified by mental health staff.”
The paper relies on this without support.
Positive symptoms tend to be prioritised for monitoring and assessment over depression in this population.
“Positive symptoms tended to be prioritised for monitoring and assessment”
The paper relies on this without support.
There is poor discrimination between negative symptoms and depression.
“there was poor discrimination between negative symptoms and depression”
The paper relies on this without support.
Conversations about depressed mood and hopelessness are frequently avoided.
“conversations about depressed mood and hopelessness were frequently avoided.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
2/39 (5%) studies provided a clear definition of serious adverse events.
“In terms of operationalising harm, 2/39 (5%) studies provided a clear definition of serious adverse events (Gumley et al., 2017;Jacobsen et al., 2020)”
From Systematic review of the safety of mindfulness-based interventions for psychosis (2024) · cites this paper as Gumley et al., 2017
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Psychological-flexibility estimate lies outside its confidence interval
MajorThe reported 5-month coefficient, -0.883, is outside the entirely negative confidence interval. The interval's midpoint is -8.825, not -0.883.
Reported -0.883 · recomputed -8.825
“(Coeff=-0.883, 95%CI -14.94, -2.71, p<0.01)”
Per-protocol BDI confidence interval has the wrong sign
MajorThe stated 5-month coefficient is -10.18, but the printed confidence limits have a midpoint of 7.505. The positive lower limit also places the estimate outside its interval.
Reported -10.18 · recomputed 7.505
“(Coeff=-10.18, 95%CI 17.69, -2.68, p=0.01)”
PANSS Excitement estimate lies outside its confidence interval
MajorThe reported coefficient is positive (1.98), whereas both confidence limits are negative; their midpoint is -1.975.
Reported 1.98 · recomputed -1.975
“(Coeff=1.98, 95%CI -3.60, -0.35, p=0.019)”
Per-protocol PANSS Cognitive Disorganisation interval conflicts with its estimate
MajorThe printed interval has a midpoint of -7.11 rather than the stated coefficient of -6.16. It also includes zero despite the reported p=0.003 and description of a significant effect.
Reported -6.16 · recomputed -7.11
“PANSS Cognitive Disorganisation (Coeff=-6.16, 95%CI -15.49, 1.27, p=0.003)”
Per-protocol PANSS Negative estimate lies outside its confidence interval
MajorThe coefficient is -4.03, but the printed interval runs from 10.01 to -2.30. Its midpoint is 3.855, and it does not contain the coefficient.
Reported -4.03 · recomputed 3.855
“PANSS Negative (Coeff=-4.03, 95%CI 10.01, -2.30, p=0.04)”
Discussion denies observer-rated signals reported in Results
MinorThe Discussion says there was no signal on any observer-based measure, but the Results report significant effects on PANSS symptom ratings.
“lack of any signal on any observer based measures in our study is an important consideration.”
“there was a significant effect in favour of ACTdp+SC on PANSS Cognitive Disorganisation (Coeff=-4.92, 95%CI -8.50, -1.35, p=0.01)”
Cites
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995 · see citing works
Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., Bonsel, G., & Badia, X. (2011) · Quality of Life Research · doi:10.1007/s11136-011-9903-x · Cited by 9,795 · see citing works
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.03.007 · Cited by 3,950 · see citing works
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008) · Assessment · doi:10.1177/1073191107313003 · Cited by 2,930 · see citing works
Autobiographical memory specificity and emotional disorder.
Williams, J. M. G., Barnhofer, T., Crane, C., Herman, D., Raes, F., Watkins, E., & Dalgleish, T. (2007) · Psychological Bulletin · doi:10.1037/0033-2909.133.1.122 · Cited by 1,688 · see citing works
Autobiographical memory in suicide attempters.
Williams, J. M., & Broadbent, K. (1986) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.95.2.144 · Cited by 1,330 · see citing works
A depression rating scale for schizophrenics
Addington, D. E., Addington, J., & Schıssel, B. (1990) · Schizophrenia Research · doi:10.1016/0920-9964(90)90005-r · Cited by 1,270 · see citing works
Response styles and the duration of episodes of depressed mood.
Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.102.1.20 · Cited by 1,212 · see citing works
Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm114 · Cited by 1,029 · see citing works
Bach, P., & Hayes, S. C. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.5.1129 · Cited by 839 · see citing works
Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2007) · Behavior Modification · doi:10.1177/0145445507302202 · Cited by 687 · see citing works
Insight in schizophrenia: a meta-analysis
Mintz, A. R., Dobson, K. S., & Romney, D. M. (2003) · Schizophrenia Research · doi:10.1016/s0920-9964(02)00316-x · Cited by 563 · see citing works
van der Gaag, M., Hoffman, T. O., REMIJSEN, M., Hijman, R., DEHAAN, L., VANMEIJEL, B., VANHARTEN, P., Valmaggia, L., DEHERT, M., & CUIJPERS, A. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2006.03.021 · Cited by 555 · see citing works
Jauhar, S., McKenna, P. J., Radua, J., Fung, E., Salvador, R., & Laws, K. R. (2014) · British Journal of Psychiatry · doi:10.1192/bjp.bp.112.116285 · Cited by 517 · see citing works
Chisholm, D., Knapp, M. R. J., Knudsen, H. C., Amaddeo, F., Gaite, L., van Wijngaarden, B., & EPSILON Study Group (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.39.s28 · Cited by 480 · see citing works
Gaudiano, B. A., & Herbert, J. D. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.02.007 · Cited by 435 · see citing works
Whither trial‐based economic evaluation for health care decision making?
Sculpher, M. J., Claxton, K., Drummond, M., & McCabe, C. (2006) · Health Economics · doi:10.1002/hec.1093 · Cited by 408 · see citing works
Neil, S. T., Kilbride, M., Pitt, L., Nothard, S., Welford, M., Sellwood, W., & Morrison, A. P. (2009) · Psychosis · doi:10.1080/17522430902913450 · Cited by 362 · see citing works
Angermeyer, M. C., Matschinger, H., & Corrigan, P. W. (2004) · Schizophrenia Research · doi:10.1016/s0920-9964(03)00186-5 · Cited by 354 · see citing works
Birchwood, M., Iqbal, Z., Chadwick, P., & Trower, P. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.6.516 · Cited by 315 · see citing works
Quality of life of people with schizophrenia, bipolar disorder and other psychotic disorders
Saarni, S. I., Viertiö, S., Perälä, J., Koskinen, S., Lönnqvist, J., & Suvisaari, J. (2010) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.076489 · Cited by 251 · see citing works
Suicide among schizophrenics: A review
Drake, R. E., Whitaker, A., Gates, C., & Cotton, P. G. (1985) · Comprehensive Psychiatry · doi:10.1016/0010-440x(85)90053-7 · Cited by 240 · see citing works
Bohlmeijer, E. T., Fledderus, M., Rokx, T. A. J. J., & Pieterse, M. E. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.10.003 · Cited by 232 · see citing works
Iqbal, Z., Birchwood, M., Chadwick, P., & Trower, P. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.6.522 · Cited by 226 · see citing works
The evolution of insight, paranoia and depression during early schizophrenia
DRAKE, R. J., PICKLES, A., BENTALL, R. P., KINDERMAN, P., HADDOCK, G., TARRIER, N., & LEWIS, S. W. (2004) · Psychological Medicine · doi:10.1017/s0033291703008821 · Cited by 204 · see citing works
Selecting outcome measures in mental health: the views of service users
Crawford, M. J., Robotham, D., Thana, L., Patterson, S., Weaver, T., Barber, R., Wykes, T., & Rose, D. (2011) · Journal of Mental Health · doi:10.3109/09638237.2011.577114 · Cited by 172 · see citing works
White, R., Gumley, A., McTaggart, J., Rattrie, L., McConville, D., Cleare, S., & Mitchell, G. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.09.003 · Cited by 161 · cited 3× · see citing works
“Of the 5 RCTs of ACTp (Bach and Hayes, 2002; Gaudiano and Herbert, 2006; White et al., 2011; Shawyer et al., 2007; Gaudiano et al., 2015) the mean sample size is Table 4”
Self-citationThe voices acceptance and action scale (VAAS): Pilot data
Shawyer, F., Ratcliff, K., Mackinnon, A., Farhall, J., Hayes, S. C., & Copolov, D. (2007) · Journal of Clinical Psychology · doi:10.1002/jclp.20366 · Cited by 136 · see citing works
Hacker, T., Stone, P., & MacBeth, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.053 · Cited by 130 · cited 1× · see citing works
“Randomised controlled trials show that ACT reduces depression in non-psychotic populations (Hacker et al., 2016).”
Fowler, D., Hodgekins, J., Painter, M., Reilly, T., Crane, C., Macmillan, I., Mugford, M., Croudace, T., & Jones, P. B. (2009) · Psychological Medicine · doi:10.1017/s0033291709005467 · Cited by 125 · see citing works
Berking, M., Neacsiu, A., Comtois, K. A., & Linehan, M. M. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.04.011 · Cited by 124 · see citing works
Addington, J., Shah, H., Liu, L., & Addington, D. E. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2013.12.014 · Cited by 121 · see citing works
Vancampfort, D., Probst, M., Scheewe, T., Maurissen, K., Sweers, K., Knapen, J., & De Hert, M. (2011) · Schizophrenia Research · doi:10.1016/j.schres.2011.03.018 · Cited by 113 · see citing works
A Compassion Focused Model of Recovery after Psychosis
Gumley, A. I., Braehler, C., Laithwaite, H., MacBeth, A. M., & Gilbert, P. (2010) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2010.3.2.186 · Cited by 102 · see citing works
Self-citationAntidepressants for people with both schizophrenia and depression
Whitehead, C., Moss, S., Cardno, A., Lewis, G., & Furtado, V. A. (2002) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002305 · Cited by 92 · see citing works
Diagnostic validity of assessment scales for depression in patients with schizophrenia
Kim, S.-W., Kim, S.-J., Yoon, B.-H., Kim, J.-M., Shin, I.-S., Hwang, M. Y., & Yoon, J.-S. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2005.10.002 · Cited by 88 · see citing works
Depressive and negative symptoms in schizophrenia: different effects on clinical features
Rocca, P., Bellino, S., Calvarese, P., Marchiaro, L., Patria, L., Rasetti, R., & Bogetto, F. (2005) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2004.09.001 · Cited by 76 · see citing works
Wichniak, A., Skowerska, A., Chojnacka-Wójtowicz, J., Tafliński, T., Wierzbicka, A., Jernajczyk, W., & Jarema, M. (2011) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.05.009 · Cited by 75 · see citing works
Rating Depression in Schizophrenia
Addington, D. E., Addington, J., & Maticka‐Tyndale, E. (1993) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199309000-00006 · Cited by 42 · see citing works
Assessment and treatment of suicide risk in schizophrenia
Pompili, M., Lester, D., Innamorati, M., Tatarelli, R., & Girardi, P. (2007) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.8.1.51 · Cited by 40 · see citing works
Acceptance-based Behavior Therapy for Depression With Psychosis
GAUDIANO, B. A., BUSCH, A. M., WENZE, S. J., NOWLAN, K., EPSTEIN-LUBOW, G., & MILLER, I. W. (2015) · Journal of Psychiatric Practice · doi:10.1097/pra.0000000000000092 · Cited by 37 · see citing works
White, R. G., Gumley, A. I., McTaggart, J., Rattrie, L., McConville, D., Cleare, S., & Mitchell, G. (2013) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465812000239 · Cited by 37 · see citing works
Self-citationThe burden of depressive symptoms in people with schizophrenia
Conley, R. R. (2009) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2009.09.001 · Cited by 28 · see citing works
White, R. G., Gumley, A. I., McTaggart, J., Rattrie, L., McConville, D., Cleare, S., McLeod, H. J., & Mitchell, G. (2015) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2015.06.004 · Cited by 13 · cited 1× · see citing works
“In a later analysis, White et al. (2015) found that ACT was associated with significantly greater likelihood of achieving a clinically significant improvement in depression.”
Self-citationIncorporating Acceptance and Mindfulness into the Treatment of Psychosis
(2015) · Oxford University Press eBooks · doi:10.1093/med:psych/9780199997213.001.0001 · Cited by 9 · see citing works
New methods of analysing cost effectiveness
Briggs, A. H. (2007) · BMJ · doi:10.1136/bmj.39332.587581.be · Cited by 6 · see citing works
Self-citationSchizophrenia and bipolar disorder: No recovery without suicide prevention
Foster, T. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.115.165944 · Cited by 3 · see citing works
Treating depression in psychosis: self-compassion as a valued life direction
White, R. G. (2015) · ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) · Cited by 2 · see citing works
Self-citationGumley, A., White, R., Briggs, A., Ford, I., Barry, S., Stewart, C., Beedie, S., Clarke, C., MacLeod, R., Lidstone, E., et al. (2016) · Psychosis · doi:10.1080/17522439.2015.1100669 · Cited by 2 · see citing works
Self-citationTreating Depression in Psychosis
White, R. G. (2015) · Oxford University Press eBooks · doi:10.1093/med:psych/9780199997213.003.0005 · Cited by 1 · see citing works
Self-citation
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Treatable clinical intervention targets for patients with schizophrenia
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Macri, J. A., & Rogge, R. D. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102432 · Cited by 89 · see citing works
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Yıldız, E. (2020) · Perspectives in Psychiatric Care · doi:10.1111/ppc.12396 · Cited by 67 · see citing works
Seshadri, A., Orth, S. S., Adaji, A., Singh, B., Clark, M. M., Frye, M. A., McGillivray, J., & Fuller-Tyszkiewicz, M. (2021) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20200006 · Cited by 42 · see citing works
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REN, Z., ZHAO, C., BIAN, C., ZHU, W., JIANG, G., & ZHU, Z. (2019) · Acta Psychologica Sinica · doi:10.3724/sp.j.1041.2019.00662 · Cited by 36 · see citing works
Cuijpers, P. J., Miguel, C., Čihařová, M., Quero, S., Plessen, C. Y., Ebert, D. D., Harrer, M., van Straten, A., & Karyotaki, E. (2023) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2023.2166578 · Cited by 30 · see citing works
Yip, A. L. K., Karatzias, T., & Chien, W. T. (2022) · Annals of Medicine · doi:10.1080/07853890.2022.2108551 · Cited by 24 · see citing works
Vakilian, K., Zarei, F., & Majidi, A. (2019) · Iranian Red Crescent Medical Journal · doi:10.5812/ircmj.89489 · Cited by 22 · see citing works
Shi, J.-Y., Cao, Y.-M., Luo, H.-Y., Liu, S., Yang, F.-M., & Wang, Z.-H. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.03.042 · Cited by 19 · see citing works
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Gaudiano, B. A., Ellenberg, S., Ostrove, B., Johnson, J. E., Mueser, K. T., Furman, M. A., & Miller, I. W. (2020) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.34.1.80 · Cited by 17 · see citing works
Steel, C., Korrelboom, K., Baksh, M. F., Kingdon, D., Simon, J., Wykes, T., Phiri, P., & van der Gaag, M. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103734 · Cited by 17 · see citing works
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Reich, D., Evans, S., Nelson, B., Hickey, T., & O’Shea, M. (2021) · Mindfulness · doi:10.1007/s12671-021-01611-x · Cited by 9 · see citing works
Shame, social deprivation, and the quality of the voice‐hearing relationship
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Ellett, L., & Kingston, J. L. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-815012-2.00016-x · Cited by 7 · see citing works
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Larsson, C., Fatouros-Bergman, H., Isaksson, A., Johansson, M., Kaldo, V., Parling, T., & Lundgren, T. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.05.008 · Cited by 5 · see citing works
van Aubel, E., Vaessen, T., van Winkel, R., Lafit, G., Klippel, A., Viechtbauer, W., Batink, T., van der Gaag, M., van Amelsvoort, T., Marcelis, M. C., et al. (2022) · medRxiv · doi:10.1101/2022.01.19.22269524 · Cited by 5 · see citing works
Yıldız, E., & Aylaz, R. (2020) · Clinical Nursing Research · doi:10.1177/1054773820935592 · Cited by 4 · see citing works
Анатольевна, С. О., Zhirnova, O. V., & Truevtsev, D. V. (2020) · Clinical Psychology and Special Education · doi:10.17759/cpse.2020090202 · Cited by 4 · see citing works
Pena-Garijo, J., Mor, T. B., & Martı́nez-Raga, J. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i8.107313 · Cited by 2 · see citing works
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Gil‐Luciano, B., Ruiz, F. J., & Luciano, C. (2023) · Springer eBooks · doi:10.1007/978-3-031-27003-1_12 · Cited by 1 · see citing works
Telschow, L., Voß, H., Bechdolf, A., Sachsenheimer, F., Wagler, S., Lehmann, B., Kadoum, A., Schulze, M., Decker, R., Pössnecker, Y., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-10032816/v1 · Cited by 1 · see citing works
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DUCASSE, D., VAN GORDON, W., & COURTET, P. (2021) · Minerva Psychiatry · doi:10.23736/s2724-6612.21.02152-7
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Nicholls, J., Newman, E., & Morris, E. M. J. (2023) · Springer eBooks · doi:10.1007/978-3-031-27003-1_16
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González-Amado, L., Menéndez, A. G., Fernández-García, M., Paíno, M., & Krotter, A. (2026) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-026-09748-3
Voß, H., Telschow, L., Bechdolf, A., Berghöfer, A., Sachsenheimer, F., Wagler, S., Lehmann, B., Jäckel, D., Pössnecker, Y., & Ehlen, F. (2026) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.70113
- Authors
- Gumley, A., White, R., Briggs, A., Ford, I., Barry, S., Stewart, C., Beedie, S., McTaggart, J., Clarke, C., MacLeod, R., Lidstone, E., Riveros, B. S., Young, R., & McLeod, H.
- Affiliations
- University of Glasgow (GB)
- University of Liverpool (GB)
- NHS Greater Glasgow and Clyde (GB)
- Corresponding author
- Gumley, Andrew
- ORCID
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 183
- Pages
- 143-150
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W2162703405
- Semantic Scholar
- 3bad2df00fea287ccdf6f7333a186528dc908cd3
- Cited by
- 34
- References
- 51
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 7 · 2018: 4 · 2017: 1
- FWCI
- 5.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy
- MeSH terms
- Adult, Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pilot Projects, Schizophrenia, Schizophrenic Psychology, Antipsychotic Agents, Reproducibility of Results, Single-Blind Method, Treatment Outcome, Acceptance and Commitment Therapy
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