Studies in follow up and outcomes

There are a number of studies currently in follow up.

IDEAL

The IDEAL research project asks people with dementia and their families about their lives, and how they feel. It will find out what aspects of people lives help or hinder their ability to live well with dementia.

If you’ve experiences changes in memory or other thinking abilities and have a family member or close friends who would be interested in taking part in this study please contact Carol Long [email protected] or on 01642 283501.

Scimitar +

The SCIMITAR+ trial will examine whether a bespoke smoking cessation intervention works better than existing smoking cessation services in helping people with severe mental illness quit smoking. Participants will be randomised to either the bespoke trial intervention or smoking cessation treatment as usual.

For more information please contact [email protected]

E-compared

The E-compared study will conduct comparative effectiveness research in IAPT settings on the effectiveness of internet-based treatment for depression in comparison with standard care. Participants allocated in the intervention arm will receive 11 weekly therapy sessions overall: six face to face and five internet based.

For more information please contact [email protected]

Outcomes of Research Studies

Modelling BSL-IAPT and Standard IAPT accessed by deaf people

‘Evaluating the effectiveness and cost-effectiveness of British Sign Language Improving Access to Psychological Therapies: an exploratory study’

British Sign Language (BSL) is a fully grammatical visual language separate from English. Rates of anxiety and depression are much higher among deaf people who use BSL than among the general population.

This study compares two kinds of service for deaf people experiencing mental health problems. In the first, standard Improving Access to Psychological Therapies (IAPT), the therapist and deaf person usually communicate using a sign language interpreter. In the second, the therapist is a deaf person who uses the same language as the client, namely BSL.

We wanted to find out which was best at helping the deaf client recover and which was better value for money. Before we could do that we also needed to develop some new measurement tools. The ones usually used to assess progress in therapy and how healthy someone feels were not available in BSL. We also needed to find out about whether or not there were differences in how standard IAPT services treated deaf BSL users. We have now developed new versions in BSL of common assessments used to measure anxiety, depression and health.

We found out that there is little difference in the recovery levels of deaf people who use either BSL-IAPT or standard IAPT. However, this result is not strong because most standard IAPT services had seen hardly any deaf people. It is not certain whether or not BSL-IAPT is better value than standard IAPT using an interpreter to achieve the same outcomes for clients.

A BSL version of this summary is available.

Read the full report.

PrOVIDe study

Dementia is a major public health problem in the developed world. Approximately 750,000 people in the UK have some form of dementia. A recent survey found that around 40% of optometrists regularly, and 58% occasionally, examine patients with dementia. The profession has a role to play in creating more dementia-friendly practices. Some of the resources available to optometrists on dementia and its management are discussed in this article.

The Trust played a role in the PrOVIDe study (Prevalence of Visual Impairment in Dementia), led by the College of Optometrists, between 31 January 2012 and 30 September 2014.

We recruited 93 participants to the study, which investigated the prevalence of visual impairment on the attitudes and experiences of people with dementia, carers and optometrists.

One conclusion from the PrOVIDe study is that a Dementia Eye Care Pathway, by formally acknowledging the individual’s right to information and appropriate eye care services, could reduce the prevalence of visual impairment in people with dementia and the considerable impact of visual impairment on an individual’s quality of life.

AMyloid imaging for Phenotyping LEwy body Dementia (AMPLE) Study

The AMPLE study used PET imaging to look at the amount and distribution of beta-amyloid within three groups of volunteers: those with alzheimers disease, dementia with lewy bodies and healthy controls. The study aimed to understand and determine the relationship between amyloid levels, clinical features of the disease, other imaging changes and subsequent clinical course.

Recruitment took place from 3 June 2013 to 21 march 2016. We recruited four patients to the total of 77.

The overall results of the study indicated there was a range of beta-amyloid levels in those with DLB, as 54% of the positive scans were found in the DLB volunteers. This was significantly greater than the controls and those with AD. Also, there was no significant difference between amyloid +ve and amyloid –ve DLB cases with regards overall cognitive impairment, level of functional impairment, or any other clinical or cognitive scale. However, there was a trend for some subtle imaging changes suggestive of alzheimer’s disease (medial temporal atrophy and hypoperfusion) to be associated with the presence of amyloid in DLB. It was also found that low amyloid deposition was not associated with lower rates of cognitive disturbance or higher rates of other typical DLB characteristics.

Based on the findings, longitudinal follow-ups will take place with the cohort to determine whether amyloid deposition is associated with differences in disease progression.

SCIMITAR

The physical health of people with severe mental ill health (SMI) is often poor with people with a diagnosis of schizophrenia who are reported to die 20 to 25 years earlier than those in the general population. One of the largest contributory factors to this early mortality is smoking. The study found on average people with SMI who smoke die nearly 10 years earlier than those who do not.

While the number of people in the general population who smoke has been steadily declining over recent decades, the number of people with SMI who smoke has not been declining at the same rate. People with SMI are still more likely to smoke and to smoke more heavily. There are widely held myths about the therapeutic function of smoking and that smoking relieves anxiety when in fact nicotine can increase anxiety. In addition, smoking is perceived by some to help alleviate depression. A systematic review has found smoking cessation to reduce depression.

Conventional NHS approaches to smoking cessation do not take into account the additional challenges that people with SMI may face when attempting to quit. To address these problems, the smoking cessation intervention for severe mental ill health trial (SCIMITAR) pilot study offered a bespoke smoking-cessation intervention, specifically tailored to people with SMI.

The aim of the SCIMITAR study was to assess its acceptability and uptake by people with SMI. The Trust recruited 26 people which found the intervention to be acceptable to people with SMI and that it was feasible to recruit and retain participants.

European long-acting antipsychotics in schizophrenia trial (EULAST)

The primary objective of the trial is to compare all cause discontinuation rates in patients with schizophrenia randomized to either one of the two depot medications (aripiprazole depot or paliperidone palmitate) with patients randomized to either one of the two oral formulations of the same medication (aripiprazole or paliperidone) over an 18 month follow-up period.

For more information, please contact [email protected]

Children and young people

Study of Inherited Metabolic Diseases

Inherited Metabolic Diseases (IMD) comprise of a wide spectrum of disorders and may cause serious symptoms and death. The study investigates these disorders in children suspected to have an IMD using a range of new generation genetic and biochemical techniques, including blood, urine and skin biopsies, which will be tested and analysed. This will give us a better understanding of what makes the children ill and hopefully provide better life changing therapies for them.

For more information, please contact [email protected]

Learning disabilities

Recruiting study information coming soon.

Forensic mental health