Developing novel interventions for disorders at the interface between mental and physical health

 

Our research is influencing care, and making a positive difference to people, and the economy. This is an example below is one of our stores of our research. See more about how our research is making a difference

One of the aims of the NIHR Maudsley BRC Affective Disorders and Interface with Medicine theme is to accelerate pathways from primary to secondary care and combine mental and physical health expertise. The team have tested modified, personalised approaches in patients with a range of health problems 

Persistent physical symptoms 

Medically unexplained symptoms, otherwise referred to as persistent physical symptoms (PPS) are debilitating to patients.  As many specific PPS syndromes share common behavioural, cognitive, and affective processes, transdiagnostic treatments might be effective for this patient group. For example, unhelpful interpretations of symptoms is a transdiagnostic mechanism based on catastrophising about the consequences of symptoms, or construing symptoms as a sign of damage.  

Irritable bowel syndrome  

While continuing to generate evidence across a variety of conditions (e.g., fibromyalgia, PPS), the most significant impact to date has been in the field of irritable bowel syndrome (IBS).  

IBS is a common gastroenterology disorder affecting 10%–20% of the population worldwide and incurs significant health costs. Theme investigators successfully completed the largest trial of cognitive behavioural therapy (CBT) in irritable bowel syndrome. The trial showed a benefit for both therapist-delivered and web-delivered CBT compared to treatment-as-usual at 12 months, demonstrating effectiveness in reducing both severity and impact of symptoms, as well as anxiety and depression, with results sustained at 24 months. 

Changing clinical practice

The CBT for IBS, including patient and therapist CBT and web delivered CBT, was then manualised. These manuals have been used to define core national clinical training competencies, which in turns have been used in the design of a national 10-day top up training for the Improving Access to Psychological Therapies services (IAPT) service through-out England.  

Theme investigators have trained over 500 IAPT therapists to date in the IBS protocol and the patient and therapist manuals are freely available for use in IAPT. 

Use at home and abroad 

Moreover, the digital CBT product is one of a handful of products approved by NICE for implementation in practice, and it has now been licensed to a US based company, Mahana Therapeutics 

Mahana have renamed the product Parallel and have had the product CE marked as a class 1 medical device for sale in the UK and Europe; they will be conducting some initial commercial pilots in IAPT and bringing it to the NHS, US and further afield.  This is the first digital product to be licenced by King’s Commercialisation Institute and a new ongoing industry collaboration led by Theme Investigators to bring digital therapeutics in the gastroenterology field to market. 

Finally, theme researchers developed an online program to target one potential transdiagnostic mechanism (interpretation bias) of distress called Flex Project. The team are currently running a randomised feasibility study of this program. 

Further reading 

Cognitive behavioural therapy for irritable bowel syndrome: 24-month follow-up of participants in the ACTIB randomised trial.   

Assessing telephone-delivered cognitive-behavioural therapy (CBT) and web-delivered CBT versus treatment as usual in irritable bowel syndrome (ACTIB): a multicentre randomised trial.  

How our research is making a difference

How our research is making a difference

Our research is influencing care, and making a positive difference to people, and the economy.
All our research stories

All our research stories

A collection of all our stories of research at the NIHR Maudsley BRC.
Changing clinical practice

Changing clinical practice

Our research impacts the techniques, treatments and systems used in healthcare for patients.

 

 


Tags: research stories - Changing clinical practice stories -

By NIHR Maudsley BRC at 30 Jan 2019, 11:27 AM


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