The wellbeing neuro course: a randomised controlled trial of an internet-delivered transdiagnostic psychological intervention for adults with neurological disorders
Abstract
Background: Mental health and functional difficulties are highly comorbid across neurological disorders, but supportive care options are limited. This randomised controlled trial assessed the efficacy of a novel transdiagnostic internet-delivered psychological intervention for adults with neurological disorders. Methods: 221 participants with a confirmed diagnosis of epilepsy, multiple sclerosis, Parkinson's disease, or an acquired brain injury were allocated to either an immediate treatment group ( n = 115) or treatment-as-usual waitlist control ( n = 106). The intervention, the Wellbeing Neuro Course, was delivered online via the eCentreClinic website. The Course includes six lessons, based on cognitive behavioural therapy, delivered over 10 weeks with support from a psychologist via email and telephone. Primary outcomes were symptoms of depression (PHQ-9), anxiety (GAD-7) and disability (WHODAS 2.0). Results: 215 participants commenced the trial (treatment n = 111; control n = 104) and were included in intention-to-treat analysis. At post-treatment, we observed significant between-group differences in depression (PHQ-9; difference = 3.07 [95% CI 2.04–4.11], g = 0.62), anxiety (GAD-7; difference = 1.87 [0.92–2.81], g = 0.41) and disability (WHODAS 2.0 difference = 3.08 [1.09–5.06], g = 0.31), that favoured treatment (all ps < 0.001). Treatment-related effects were maintained at 3-month follow-up. Findings were achieved with minimal clinician time (average of 95.7 min [ s.d. = 59.3] per participant), highlighting the public health potential of this approach to care. No adverse treatment events were reported. Conclusions: Internet-delivered psychological interventions could be a suitable model of accessible supportive care for patients with neurological disorders.
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Only one included study utilized a mixed neurological disorder sample and was underpowered to directly compare across disorders; participants with Parkinson's disease were the only subgroup that did not significantly improve.
“In fact, only one study utilized a mixed ND sample and although it was underpowered to directly compare across disorders, participants with PD were the only subgroup which did not significantly improve (Gandy et al., 2023).”
From Cognitive behavioral interventions for depression and anxiety in adults with neurological disorders: a systematic review and meta-analysis (2024) · cites this paper as Gandy et al., 2023
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Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
Patel, V., Chisholm, D., Parikh, R., Charlson, F. J., Degenhardt, L., Dua, T., Ferrari, A. J., Hyman, S., Laxminarayan, R., Levin, C., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(15)00390-6 · Cited by 889 · cited 1× · see citing works
“Poor mental health can disrupt the medical management, self-management, quality of life, and prognosis of neurological disorders (Gandy et al., 2021; Hesdorffer, 2016; Patel et al., 2016).”
BackgroundKaryotaki, E., Efthimiou, O., Miguel, C., Maas genannt Bermpohl, F., Furukawa, T. A., Cuijpers, P., Individual Patient Data Meta-Analyses for Depression (IPDMA-DE) Collaboration, Riper, H., Patel, V., Mira, A., et al. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.4364 · Cited by 866 · see citing works
Mehta, S., Peynenburg, V. A., & Hadjistavropoulos, H. D. (2019) · Journal of Behavioral Medicine · doi:10.1007/s10865-018-9984-x · Cited by 153 · see citing works
Cognitive behavioral therapy for post-stroke depression: A meta-analysis
Wang, S.-B., Wang, Y.-Y., Zhang, Q.-E., Wu, S.-L., Ng, C. H., Ungvari, G. S., Chen, L., Wang, C.-X., Jia, F.-J., & Xiang, Y.-T. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.04.011 · Cited by 150 · see citing works
Fischer, A., Schröder, J., Vettorazzi, E., Wolf, O. T., Pöttgen, J., Lau, S., Heesen, C., Moritz, S., & Gold, S. M. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)00049-2 · Cited by 143 · see citing works
Hereditary Influences on Cognitive Functioning in Older Men: A Study of 4000 Twin Pairs
Brandt, J. (1993) · Archives of Neurology · doi:10.1001/archneur.1993.00540060039014 · Cited by 131 · see citing works
Gandy, M., Pang, S. T. Y., Scott, A. J., Heriseanu, A. I., Bisby, M. A., Dudeney, J., Karin, E., Titov, N., & Dear, B. F. (2022) · PAIN · doi:10.1097/j.pain.0000000000002606 · Cited by 102 · cited 1× · see citing works
“…small to medium pooled effect size estimates of CBT for depression and anxiety in people with PD (Ghielen et al., 2019; Zhang, Yang, Song, & Jin, 2020), MS (Ghielen et al., 2019) and post-stroke (Wang et al., 2018), as well as disability for patients with chronic pain (Gandy et al., 2022).”
BackgroundSelf-citationSchröder, J., Brückner, K., Fischer, A., Lindenau, M., Köther, U., Vettorazzi, E., & Moritz, S. (2014) · Epilepsia · doi:10.1111/epi.12833 · Cited by 96 · see citing works
Karin, E., Dear, B. F., Heller, G. Z., Crane, M. F., & Titov, N. (2018) · JMIR Mental Health · doi:10.2196/mental.8363 · Cited by 67 · see citing works
Self-citationFernie, B. A., Kollmann, J., & Brown, R. G. (2015) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2015.02.012 · Cited by 51 · see citing works
Kraepelien, M., Schibbye, R., Månsson, K., Sundström, C., Riggare, S., Andersson, G., Lindefors, N., Svenningsson, P., & Kaldo, V. (2020) · Journal of Parkinson's Disease · doi:10.3233/jpd-191894 · Cited by 41 · see citing works
Gandy, M., Karin, E., Fogliati, V. J., Meares, S., Nielssen, O., Titov, N., & Dear, B. F. (2018) · Rehabilitation Psychology · doi:10.1037/rep0000241 · Cited by 37 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 27
- Andelic, N., Soberg, H. L., Berntsen, S., Sigurdardottir, S., & Roe, C. (2014). Self-perceived health care needs and delivery of health care services 5 years after moderate-to-severe traumatic brain injury. PM&R, 6(11), 1013– 1021. 10.1016/j.pmrj.2014.05.005. 24844444 · DOI
- Andersson, G., Titov, N., Dear, B. F., Rozental, A., & Carlbring, P. (2019). Internet-delivered psychological treatments: From innovation to implementation. World Psychiatry, 18(1), 20– 28. 10.1002/wps.20610. 30600624 PMC6313242 · DOI · Paper page
- Andrews, G., Kemp, A., Sunderland, M., von Korff, M., & Ustun, T. B. (2009). Normative data for the 12 item WHO disability assessment schedule 2.0 [Article]. PLoS One, 4(12), Article e8343. 10.1371/journal.pone.0008343. 20020047 PMC2791224 · DOI · Paper page
- Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26(1), 17– 31. 10.1016/j.cpr.2005.07.003. 16199119 · DOI · Paper page
- Butow, P., Dhillon, H., Shaw, J., & Price, M. (2017). Psycho-oncology in Australia: A descriptive review. BioPsychoSocial Medicine, 11(1), 15. 10.1186/s13030-017-0100-1. 29259656 PMC5731077 · DOI
- Carlbring, P., Andersson, G., Cuijpers, P., Riper, H., & Hedman-Lagerlöf, E. (2018). Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: An updated systematic review and meta-analysis. Cognitive Behaviour Therapy, 47(1), 1– 18. 10.1080/16506073.2017.1401115. 29215315 · DOI · Paper page
- Cella, D., Lai, J. S., Nowinski, C. J., Victorson, D., Peterman, A., Miller, D., & Moy, C. (2012). Neuro-QOL: Brief measures of health-related quality of life for clinical research in neurology. Neurology, 78(23), 1860– 1867. 10.1212/WNL.0b013e318258f744. 22573626 PMC3369516 · DOI
- Chalah, M. A., & Ayache, S. S. (2018). Cognitive behavioral therapies and multiple sclerosis fatigue: A review of literature. Journal of Clinical Neuroscience, 52, 1– 4. 10.1016/j.jocn.2018.03.024. 29609859 · DOI
- Chan, V., Toccalino, D., Omar, S., Shah, R., & Colantonio, A. (2022). A systematic review on integrated care for traumatic brain injury, mental health, and substance use. PLoS One, 17(3), e0264116. 10.1371/journal.pone.0264116. 35239715 PMC8893633 · DOI
- Creutzfeldt, C. J., Kluger, B., Kelly, A. G., Lemmon, M., Hwang, D. Y., Galifianakis, N. B., & Holloway, R. G. (2018). Neuropalliative care. Neurology, 91(5), 217. 10.1212/WNL.0000000000005916. 29950434 PMC6093769 · DOI
- Dear, B. F., Scott, A. J., Fogliati, R., Gandy, M., Karin, E., Dudeney, J., & Titov, N. (2022). The chronic conditions course: A randomised controlled trial of an internet-delivered transdiagnostic psychological intervention for people with chronic health conditions. Psychotherapy and Psychosomatics, 91(4), 265– 276. 10.1159/000522530. 35367986 · DOI
- Gandy, M., Heriseanu, A. I., Dudeney, J., Bisby, M. A., Scott, A. J., Fisher, A., & Dear, B. F. (2021). Disability and life satisfaction in neurological disorders: The role of depression and perceived cognitive difficulties. General Hospital Psychiatry, 73, 16– 23. 10.1016/j.genhosppsych.2021.08.013. 34508992 · DOI
- Gandy, M., Karin, E., McDonald, S., Meares, S., Scott, A. J., Titov, N., & Dear, B. F. (2020). A feasibility trial of an internet-delivered psychological intervention to manage mental health and functional outcomes in neurological disorders. Journal of Psychosomatic Research, 136, 110173. 10.1016/j.jpsychores.2020.110173. 32623193 · DOI
- Ghielen, I., Rutten, S., Boeschoten, R. E., Houniet-de Gier, M., van Wegen, E. E. H., van den Heuvel, O. A., & Cuijpers, P. (2019). The effects of cognitive behavioral and mindfulness-based therapies on psychological distress in patients with multiple sclerosis, Parkinson's disease and Huntington's disease: Two meta-analyses. Journal of Psychosomatic Research, 122, 43– 51. 10.1016/j.jpsychores.2019.05.001. 31126411 · DOI · Paper page
- Gilliam, F. G., Barry, J. J., Hermann, B. P., Meador, K. J., Vahle, V., & Kanner, A. M. (2006). Rapid detection of major depression in epilepsy: A multicentre study. The Lancet Neurology, 5(5), 399– 405. http://www.sciencedirect.com/science/article/B6X3F-4JP9FY8-1/1/2cbc3d113ff80f757992f61865cc03e1. 16632310
- Hesdorffer, D. C. (2016). Comorbidity between neurological illness and psychiatric disorders. CNS Spectrums, 21(3), 230– 238. 10.1017/S1092852915000929. 26898322 · DOI
- Karin, E., Dear, B. F., Heller, G. Z., Gandy, M., & Titov, N. (2018b). Measurement of symptom change following web-based psychotherapy: Statistical characteristics and analytical methods for measuring and interpreting change [Conference Paper]. Journal of Medical Internet Research, 20(7), Article e10200. 10.2196/10200. PMC6062691 30001999 · DOI · Paper page
- Kohrt, B. A., Griffith, J. L., & Patel, V. (2018). Chronic pain and mental health: Integrated solutions for global problems. Pain, 159(Suppl 1), S85– S90. 10.1097/j.pain.0000000000001296. 30113952 PMC6130207 · DOI
- Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 46(3), 266– 274. 10.1097/MLR.0b013e318160d093. 18388841 · DOI · Paper page
- Meyer, B., Weiss, M., Holtkamp, M., Arnold, S., Brückner, K., Schröder J., & Nestoriuc, Y. (2019). Effects of an epilepsy-specific Internet intervention (Emyna) on depression: Results of the ENCODE randomized controlled trial. Epilepsia, 60(4), 656– 668. 10.1111/epi.14673. 30802941 · DOI
- Price, A., Rayner, L., Okon-Rocha, E., Evans, A., Valsraj, K., Higginson, I. J., & Hotopf, M. (2011). Antidepressants for the treatment of depression in neurological disorders: A systematic review and meta-analysis of randomised controlled trials. Journal of Neurology, Neurosurgery and Psychiatry, 82(8), 914– 923. 10.1136/jnnp.2010.230862. 21558287 · DOI · Paper page
- Radford, K., Lah, S., Thayer, Z., Say, M. J., & Miller, L. A. (2012). Improving memory in outpatients with neurological disorders using a group-based training program. Journal of the International Neuropsychological Society 18(4), 738– 748. http://europepmc.org/abstract/MED/22594962. 22594962
- Scott, A. J., Sharpe, L., Thayer, Z., Miller, L. A., Hunt, C., MacCann, C., & Gandy, M. (2019). Design and validation of two measures to detect anxiety disorders in epilepsy: The Epilepsy Anxiety Survey Instrument and its brief counterpart. Epilepsia, 60(10), 2068– 2077. 10.1111/epi.16348. 31560136 · DOI
- Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092– 1097. http://www.scopus.com/inward/record.url?eid=2-s2.0-33646815612&partnerID=40&md5=8c60e89dae20fc8db442a4a58d8c5c30. 16717171
- Ustun, T., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., & Collaborators (2010). Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization, 88(11), 815– 823. 21076562 PMC2971503
- Waldron, B., Casserly, L. M., & O'Sullivan, C. (2013). Cognitive behavioural therapy for depression and anxiety in adults with acquired brain injury. What works for whom? Neuropsychological Rehabilitation, 23(1), 64– 101. 10.1080/09602011.2012.724196. 23121258 · DOI · Paper page
- Zhang, Q., Yang, X., Song, H., & Jin, Y. (2020). Cognitive behavioral therapy for depression and anxiety of Parkinson's disease: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 39, 101111. 10.1016/j.ctcp.2020.101111. 32379650 · DOI · Paper page
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Sorted by citations
Gandy, M., Woldhuis, T., Wu, W., Youssef, M., Bisby, M. A., Dear, B. F., Heriseanu, A. I., & Scott, A. J. (2024) · Psychological Medicine · doi:10.1017/s0033291724001995 · Cited by 20 · see citing works
“Thus, interventions with broader inclusion criteria would benefit from analyses that account for baseline symptom severity when analyzing intervention effects (Gandy et al., 2023).”
Self-citation
- Authors
- Gandy, M., Heriseanu, A. I., Balakumar, T., Karin, E., Walker, J., Hathway, T., Bisby, M. A., Scott, A. J., Dudeney, J., Fisher, A., Titov, N., & Dear, B. F.
- ORCID
- Gandy, Milena
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2023-03-01
- Volume
- 53
- Issue
- 14
- Pages
- 6817-6827
- ISSN
- 0033-2917
- 1469-8978
- PMC
- PMC10600819
- Cited by
- 15
- References
- 13
- Language
- en
- Funders
- icare (n/a)
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