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Sponsor: Institute of Mental Health, Singapore
Conditions: Depression, Anxiety Disorders
Interventions: Individual Psychotherapy, Internet-delivered Cognitive Behavioural Therapy (iCBT), Group Cognitive Behavioural Therapy (group CBT)
Countries: Singapore
Identifying predictors and understanding mechanisms of change will inform referral to psychotherapy, triage and right-siting by helping clinicians to understand how their patients are likely to benefit from clinical interventions. This study will be the first of its kind conducted in an Asian hospital setting to identify the predictors of response to individual, group and internet-delivered CBT for the treatment of depressed and anxious patients in the Institute of Mental Health (IMH), Singapore. With increasing challenges with hospital workload, there is an increasing emphasis on group and online interventions. Understanding of the factors that may predict outcome from these therapies can improve right-siting by identifying who will get better without therapy or who may not benefit from a given form of therapy and guide personalisation of care. An important biological predictor of outcome is likely to be genetic risk as it has been demonstrated that patients with greater melancholia and a family history may not be sufficiently treated with brief courses of therapy. Identifying psychological factors underlying psychological distress and determining the extent to which these factors are addressed by these interventions will help to improve and individualise existing psychotherapy and motivate new psychotherapeutic interventions.
Sex: ALL
Age: 18 Years to 99 Years
Healthy volunteers: No
Study type: INTERVENTIONAL
Inclusion Criteria:
1. For patients:
1. 18-99 years old;
2. have current or past symptoms of anxiety and/or depression;
3. able to communicate and read in English;
4. able to provide informed consent.
5. Waitlist arm:
\- Referred for psychotherapy but given a waiting time of 8 weeks or more to the first visit or not assigned to therapy at IMH.
6. Treatment as usual:
\- Not assigned to any psychotherapeutic interventions.
7. iCBT: - Referred for iCBT;
\- Identified as a 'P2' patient/appropriate for iCBT by triage.
8. Group therapy:
\- Referred for group therapy;
\- Identified as a 'P2' patient/appropriate for group therapy by triage.
9. Individual psychotherapy:
* Referred for individual therapy;
* Patient and therapist committed to frequent therapy (ideally fortnightly).
2. For therapists:
1. Therapists who will see OR have been assigned to clients in the waitlist arm, iCBT, group therapy (e.g. PsychUp), and individual psychotherapy group.
Exclusion Criteria:
1\. For patients:
1. current active suicidal intention or plan;
2. cognitively-impaired/are unable to consent/lack capacity to consent.- Singapore, Singapore, Singapore