Evidence map›Paper›PMID 29153873›Full record

Trial reportThe lancet. Psychiatry2017

Comparison of behavioural activation with guided self-help for treatment of depression in adults with intellectual disabilities: a randomised controlled trial.

Andrew Jahoda, Richard Hastings, Chris Hatton, Sally-Ann Cooper, Dave Dagnan, Ruiqi Zhang, Alex McConnachie, Nicola McMeekin, Kim Appleton, Rob Jones and 11 more

Open access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The lancet. Psychiatry, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.

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  8. Guided self-help for depression in autistic adults: the ADEPT feasibility RCT.Health technology assessment (Winchester, England) · 2019
    Trial
  9. Research Review: Emotion regulation in individuals with intellectual disability - an integrative review.Journal of child psychology and psychiatry, and allied disciplines · 2026
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 7 institutions in 2 countries.

Andrew JahodaInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK. Electronic address: Andrew.Jahoda@glasgow.ac.uk.
Richard HastingsCentre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK; Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia.
Chris HattonFaculty of Health and Medicine, University of Lancaster, Lancaster, UK.
Sally-Ann CooperInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Dave DagnanCumbria Partnership NHS Foundation Trust and University of Lancaster, Lancaster, UK.
Ruiqi ZhangInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Alex McConnachieInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Nicola McMeekinInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Kim AppletonInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Rob JonesSchool of Psychology, Bangor University, Bangor, UK.
Katie ScottInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Lauren FultonInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Rosie KnightCentre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK.
Dawn KnowlesFaculty of Health and Medicine, University of Lancaster, Lancaster, UK.
Chris WilliamsInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Andrew BriggsInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Ken MacMahonSchool of Health in Social Science, University of Edinburgh, Edinburgh, UK.
Helen LynnLearning Disability Services, NHS Ayrshire and Arran, Ayrshire, UK.
Ian SmithFaculty of Health and Medicine, University of Lancaster, Lancaster, UK.
Gail ThomasSpecialist Learning Disability Psychological Services, South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Stafford, UK.
Craig MelvilleInstitute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
University of Glasgow · GBLancaster University · GBBangor University · GBMonash Health · AUNHS Ayrshire and Arran · GBUniversity of Edinburgh · GBUniversity of Warwick · GB

Funding

Department of Health 10/104/34
6 · The paper itself

Abstract

backgroundPsychological therapies are first-line interventions for depression, but existing provision is not accessible for many adults with intellectual disabilities. We investigated the clinical and cost-effectiveness of a behavioural activation intervention (BeatIt) for people with intellectual disabilities and depression. BeatIt was compared with a guided self-help intervention (StepUp).

methodsWe did a multicentre, single-blind, randomised, controlled trial with follow-up at 4 months and 12 months after randomisation. Participants aged 18 years or older, with mild to moderate intellectual disabilities and clinically significant depression were recruited from health and social care services in the UK. The primary outcome was the Glasgow Depression Scale for people with a Learning Disability (GDS-LD) score at 12 months. Analyses were done on an intention-to-treat basis. This trial is registered with ISCRTN, number ISRCTN09753005.

findingsBetween Aug 8, 2013, and Sept 1, 2015, 161 participants were randomly assigned (84 to BeatIt; 77 to StepUp); 141 (88%) participants completed the trial. No group differences were found in the effects of BeatIt and StepUp based on GDS-LD scores at 12 months (12·03 [SD 7·99] GDS-LD points for BeatIt vs 12·43 [SD 7·64] GDS-LD points for StepUp; mean difference 0·26 GDS-LD points [95% CI -2·18 to 2·70]; p=0·833). Within-group improvements in GDS-LD scores occurred in both groups at 12 months (BeatIt, mean change -4·2 GDS-LD points [95% CI -6·0 to -2·4], p<0·0001; StepUp, mean change -4·5 GDS-LD points [-6·2 to -2·7], p<0·0001), with large effect sizes (BeatIt, 0·590 [95% CI 0·337-0·844]; StepUp, 0·627 [0·380-0·873]). BeatIt was not cost-effective when compared with StepUp, although the economic analyses indicated substantial uncertainty. Treatment costs were only approximately 3·6-6·8% of participants' total support costs. No treatment-related or trial-related adverse events were reported.

interpretationThis study is, to our knowledge, the first large randomised controlled trial assessing individual psychological interventions for people with intellectual disabilities and mental health problems. These findings show that there is no evidence that BeatIt is more effective than StepUp; both are active and potentially effective interventions.

fundingNational Institute for Health Research.

Indexed as

AdultBehavior TherapyCost-Benefit AnalysisDepressive DisorderFemaleHumansIntellectual DisabilityMaleMiddle AgedSingle-Blind MethodTreatment Outcome

Identifiers

PMID29153873
PMCPMC5714593
OpenAlexW2769435156

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.