Predicting Relapse after Stepped-Care Psychotherapy v1
Research type
Research Study
Full title
Prediction of Cases at Risk of Relapse Following Stepped-Care Psychotherapy Using a Machine Learning Approach
IRAS ID
278581
Contact name
Ben Lorimer
Contact email
Sponsor organisation
University of Sheffield
Duration of Study in the UK
0 years, 5 months, 30 days
Research summary
The National Institute for Clinical Excellence (NICE) reviewed guidelines in the last decade for depression and anxiety treatment (NICE, 2007a, 2007b, 2010, 2011), calling for a stepped-care system within mental health treatment. Part of this system involved low and high intensity psychological interventions which differ in duration, complexity and delivery methods. These methods are mostly based on cognitive behavioural therapy (CBT) principles, although other high-intensity interventions (e.g. Counselling for Depression) are also offered. However, questions are raised about the long-term effectiveness of these treatments, with relapse being common following CBT (Vittengl et al., 2007). If patients are likely to relapse post-treatment, re-referrals will cost the National Health Service (NHS) more time and money in the future. The ability to identify cases at risk of relapse would aid the efficacy of the stepped-care system, by enabling the targeting of relapse prevention interventions. A recent study (Lorimer et al., 2020) developed a prognostic tool with the aim of predicting relapse after low-intensity CBT. However, this has not yet been replicated for patients who received high-intensity psychotherapy.
Therefore, the primary aim of this study is to develop a predictive tool capable of identifying cases at risk of relapse following completion of high-intensity psychotherapy. It will accomplish this by analysing a pre-existing routine outcome dataset collected by Improving Access to Psychological Therapies (IAPT) services in South West Yorkshire between 01/04/2019 - 31/05/2021. These services provide follow-up appointments (occurring up to 12 months post-treatment) to patients following treatment completion. Further objectives of this study include: 1) estimation of recovery and relapse rates at follow-up; 2) identification of risk factors associated with relapse; 3) comparison between relapse after low-intensity CBT and relapse after high-intensity psychotherapy in terms of prevalence and risk factors; and 4) exploration of whether the delivery of follow-up review appointments protects against relapse.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
20/NE/0275
Date of REC Opinion
14 Dec 2020
REC opinion
Favourable Opinion