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Can we mitigate the psychological impacts of social isolation using behavioural activation? Long-term results of the UK BASIL urgent public health COVID-19 pilot randomised controlled trial and living systematic review.
Littlewood, Elizabeth; McMillan, Dean; Chew Graham, Carolyn; Bailey, Della; Gascoyne, Samantha; Sloane, Claire; Burke, Lauren; Coventry, Peter; Crosland, Suzanne; Fairhurst, Caroline; Henry, Andrew; Hewitt, Catherine; Baird, Kalpita; Ryde, Eloise; Shearsmith, Leanne; Traviss-Turner, Gemma; Woodhouse, Rebecca; Webster, Judith; Meader, Nick; Churchill, Rachel; Eddy, Elizabeth; Heron, Paul; Hicklin, Nisha; Shafran, Roz; Almeida, Osvaldo; Clegg, Andrew; Gentry, Tom; Hill, Andrew; Lovell, Karina; Dexter-Smith, Sarah; Ekers, David; Gilbody, Simon.
Afiliación
  • Littlewood E; Health Sciences, University of York, York, UK.
  • McMillan D; Health Sciences, University of York, York, UK.
  • Chew Graham C; Centre for Health and Population Science, Hull York Medical School, Hull, UK.
  • Bailey D; School of Medicine, Keele University, Keele, UK.
  • Gascoyne S; Health Sciences, University of York, York, UK.
  • Sloane C; Health Sciences, University of York, York, UK.
  • Burke L; Health Sciences, University of York, York, UK.
  • Coventry P; Health Sciences, University of York, York, UK.
  • Crosland S; Health Sciences, University of York, York, UK.
  • Fairhurst C; York Environmental Sustainability Institute, University of York, York, UK.
  • Henry A; Health Sciences, University of York, York, UK.
  • Hewitt C; Health Sciences, University of York, York, UK.
  • Baird K; Health Sciences, University of York, York, UK.
  • Ryde E; Health Sciences, University of York, York, UK.
  • Shearsmith L; Health Sciences, University of York, York, UK.
  • Traviss-Turner G; Health Sciences, University of York, York, UK.
  • Woodhouse R; Research and Development Unit, Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK.
  • Webster J; Faculty of Medicine and Health, University of Leeds, Leeds, UK.
  • Meader N; Faculty of Medicine and Health, University of Leeds, Leeds, UK.
  • Churchill R; Health Sciences, University of York, York, UK.
  • Eddy E; Research and Development Unit, Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, UK.
  • Heron P; Faculty of Medical Sciences, University of Newcastle, Newcastle upon Tyne, UK.
  • Hicklin N; Cochrane Common Mental Disorders Group, University of York, York, UK.
  • Shafran R; Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
  • Almeida O; Health Sciences, University of York, York, UK.
  • Clegg A; Department of Psychology, Royal Holloway University of London, Egham, UK.
  • Gentry T; PPP, University College London Institute of Child Health, London, UK.
  • Hill A; Paediatric Psychology Services, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
  • Lovell K; UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia.
  • Dexter-Smith S; Faculty of Medicine and Health, University of Leeds, Leeds, UK.
  • Ekers D; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK.
  • Gilbody S; Health and Care Policy, Age UK, London, UK.
Evid Based Ment Health ; 25(e1): e49-e57, 2022 12.
Article en En | MEDLINE | ID: mdl-36223980
BACKGROUND: Behavioural and cognitive interventions remain credible approaches in addressing loneliness and depression. There was a need to rapidly generate and assimilate trial-based data during COVID-19. OBJECTIVES: We undertook a parallel pilot RCT of behavioural activation (a brief behavioural intervention) for depression and loneliness (Behavioural Activation in Social Isolation, the BASIL-C19 trial ISRCTN94091479). We also assimilate these data in a living systematic review (PROSPERO CRD42021298788) of cognitive and/or behavioural interventions. METHODS: Participants (≥65 years) with long-term conditions were computer randomised to behavioural activation (n=47) versus care as usual (n=49). Primary outcome was PHQ-9. Secondary outcomes included loneliness (De Jong Scale). Data from the BASIL-C19 trial were included in a metanalysis of depression and loneliness. FINDINGS: The 12 months adjusted mean difference for PHQ-9 was -0.70 (95% CI -2.61 to 1.20) and for loneliness was -0.39 (95% CI -1.43 to 0.65).The BASIL-C19 living systematic review (12 trials) found short-term reductions in depression (standardised mean difference (SMD)=-0.31, 95% CI -0.51 to -0.11) and loneliness (SMD=-0.48, 95% CI -0.70 to -0.27). There were few long-term trials, but there was evidence of some benefit (loneliness SMD=-0.20, 95% CI -0.40 to -0.01; depression SMD=-0.20, 95% CI -0.47 to 0.07). DISCUSSION: We delivered a pilot trial of a behavioural intervention targeting loneliness and depression; achieving long-term follow-up. Living meta-analysis provides strong evidence of short-term benefit for loneliness and depression for cognitive and/or behavioural approaches. A fully powered BASIL trial is underway. CLINICAL IMPLICATIONS: Scalable behavioural and cognitive approaches should be considered as population-level strategies for depression and loneliness on the basis of a living systematic review.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ocimum basilicum / COVID-19 Tipo de estudio: Clinical_trials / Systematic_reviews Aspecto: Determinantes_sociais_saude Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Evid Based Ment Health Asunto de la revista: PSICOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ocimum basilicum / COVID-19 Tipo de estudio: Clinical_trials / Systematic_reviews Aspecto: Determinantes_sociais_saude Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Evid Based Ment Health Asunto de la revista: PSICOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido