Evidence map›Paper›PMID 40113435›Full record

Trial reportJournal of child psychology and psychiatry, and allied disciplines2025

Sudden gains in modular CBT for mental health disorders in children and young people with epilepsy.

Alvin Richards-Belle, Daniela Linton, J Helen Cross, Isobel Heyman, Emma Dalrymple, Bruce Chorpita, Sophia Varadkar, Mariam Shah, MICE Study Group, Roz Shafran and 1 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of child psychology and psychiatry, and allied disciplines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Alvin Richards-BelleDivision of Psychiatry, University College London, London, UK.ORCID 0000-0001-8577-9380
Daniela LintonUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
J Helen CrossUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Isobel HeymanUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Emma DalrympleUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Bruce ChorpitaDepartment of Psychology, University of California, Los Angeles, CA, USA.
Sophia VaradkarUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Mariam ShahUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
MICE Study Group
Roz ShafranUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Sophie BennettUCL Great Ormond Street Institute of Child Health, University College London, London, UK.

Funding

National Institute for Health and Care Research RP-PG-0616-20007Wellcome TrustWellcome Trust 218497/Z/19/Z
6 · The paper itself

Abstract

backgroundSudden gains (rapid, large, stable improvements in symptoms) are common in psychological therapy and are associated with favourable outcomes, but no studies have investigated sudden gains in children and young people (CYP) with a chronic physical condition.

methodsWithin-group study nested in the Mental Health Intervention for Children with Epilepsy (MICE) randomised trial of modular cognitive-behavioural therapy for CYP with epilepsy, utilising goal-based outcomes (GBOs) and standardised session-by-session measures (including the brief parental self-efficacy scale and Strengths and Difficulties Questionnaire [SDQ] session-by-session measure). The occurrence and potential predictors of sudden gains, and the association of sudden gains with outcomes at final session and follow-up were investigated using multivariable logistic and linear regression.

resultsAmong 147 participants (mean age: 10.4 years, 49% female) and across nine measures, 39% experienced between two and four sudden gains, most frequently on the mean GBO (occurrence, 44.9%). Characteristics such as intellectual disability, pretreatment scores and the number of sessions received were associated with significantly greater odds of sudden gains in some measures, whereas nonwhite ethnicity and nonemployment of the primary caregiver were associated with reduced odds. Sudden gains were associated with favourable final-session scores for mean GBO (GBO, adjusted mean difference [aMD]: 0.9, 95% CI: 0.3 to 1.6, p = .004, D = 0.63), parental self-efficacy (aMD: 1.2, 95% CI, 0.1 to 2.4, p = .027, D = 0.37) and the SDQ session-by-session measure (aMD: -1.7, 95% CI, -3.0 to -0.3, p = .014, D = -0.44), but not with 6-month adjusted SDQ total difficulties scores.

conclusionsSudden gains were common in this population, occurring most frequently on personalised measures, and were associated with favourable final-session scores. Personalised measures taken at each session with a focus on sudden gains may be a useful adjunct to treatment. Future research and clinical practice should investigate how to increase the occurrence of sudden gains in CYP with long-term conditions receiving psychological therapy.

Indexed as

Cognitive Behavioral TherapyEpilepsyMental DisordersOutcome Assessment, Health CareAdolescentChildFemaleHumansMaleCBTChildren and young peopleepilepsylong‐term conditionsmental health disorders

Identifiers

PMID40113435
PMCPMC12447670

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.