Anxiety Disorders studies

Summary

To find out whether tailored Acceptance and Commitment Therapy (ACT) is helpful for older people with Treatment-Resistant GAD and whether it represents value for money in a larger clinical trial. Test if ACT plus usual care leads to greater reduction in anxiety than usual care alone at 6 months, and follow up after 12 months. 

Inclusion criteria

For older people with TR-Generalised Anxiety Disorder:

1. People aged 60+ 

2. Diagnosis of GAD using the Mini-International Neuropsychiatric Interview (MINI)

3. GAD that is ‘treatment resistant’, defined as GAD that has failed to respond adequately to pharmacotherapy and/or psychotherapy treatment, as described in step 3 of the UK’s stepped care model for GAD. GAD that has failed to respond adequately defined as continued symptoms of GAD that are still causing difficulties.  Those who have been offered pharmacotherapy and/or psycho-therapy and did not want to start or continue it and are still symptomatic are included in this definition. When determining whether GAD has failed to respond adequately to treatment, if a person has remitted and then relapsed in relation to GAD, then any treatment received prior to remission will not be considered when deciding whether they meet criteria for TR-GAD.

4. Living in the community (i.e., those living in domestic residences or assisted-living facilities, but not care homes).

The MINI has been modified for the purpose of this trial with questions surrounding suicidality removed. The expression of suicidal ideation with active suicidal behaviours/plans and active intent is instead assessed via the Geriatric Suicide Ideation Scale, as detailed in the principle exclusion criteria.

For study therapists completing the qualitative satisfaction questionnaire:

1. Aged 18+

2. Therapists involved in intervention delivery within the CONTACT-GAD trial.

Exclusion criteria

For older people with TD-GAD:

1. Judged to lack capacity to provide fully informed written consent to participate in the trial.

2. A diagnosis of dementia or intellectual disability using standard diagnostic guidelines, or clinically judged to have moderate or severe cognitive impairment (e.g., due to probable dementia, traumatic brain injury, stroke, etc.)

3. A diagnosis of an imminently life-limiting illness where they would not be expected to survive for the duration of the study.

4. Expressing suicidal ideation with active suicidal behaviours/ plans and active intent, as assessed using the Geriatric Suicide Ideation Scale, for whom an inpatient admission would be more appropriate.

5. Currently receiving a course of formal psychological therapy delivered by a formally trained psychologist or psychotherapist (e.g., CBT, psychodynamic therapy, systemic therapy, counselling, etc.) or those who are unwilling to refrain from engaging in such formal psychological therapy should they be randomly allocated to the ACT arm.

6. Self-report having received ACT in the FACTOID feasibility study

7. Having already been randomised in the CONTACT_GAD trial or living with another person who has already been randomised in the CONTACT-GAD trial.

8. Taking part in clinical trials of other interventions for GAD.

Targeted, end date and PI

EPUT: 10

24.05.23

PI: Gill Blostone

Study Lead: Elizabeth Phillips

Summary

To understand the causes of depression and anxiety and to develop new treatments. Recruiting a large number of participants who will provide responses to a comprehensive set of questions. The participants will be recruited into an existing biobank, the NIHR BioResource for Translational Research in Common and Rare Diseases, a recontactable biobank.

Inclusion criteria

1. Participants who may have suffered or have been diagnosed with depression or anxiety. 

2. Participants who are aged 16 or over.

3. Participants who have not stated their refusal to take part in future research.

Exclusion criteria

1. Individual without the capacity to provide informed consent. 

2. Individuals under the age of 16 years.

3. Individuals who do not have a current diagnosis of who do not meet the screening criteria for a lifetime DSM-5 diagnosis of depression or anxiety.

Targeted, end date and PI

EPUT: 350

01.09.28

PI: Nicola Armstrong 

Study Lead: Elizabeth Phillips​