Behavioural activation versus guided self-help for depression in adults with learning disabilities: the BeatIt RCT

Jahoda A, Hastings R, Hatton C, Cooper S-A, McMeekin N, Dagnan D, Appleton K, Scott K, Fulton L, Jones R, McConnachie A, Zhang R, Knight R, Knowles D, Williams C, Briggs A, Melville C
Record ID 32018000279
Authors' objectives: The trial investigated the clinical effectiveness and cost-effectiveness of behavioural activation for depression experienced by people with mild to moderate learning disabilities. The intervention was compared with a guided self-help intervention.
Authors' results and conclusions: Results: There were 161 participants randomised (BeatIt, n = 84; StepUp, n = 77). Participant retention was strong, with 141 completing the trial. Most completed therapy (BeatIt: 86%; StepUp: 82%). At baseline, 63% of BeatIt participants and 66% of StepUp participants were prescribed antidepressants. There was no statistically significant difference in GDS-LD scores between the StepUp (12.94 points) and BeatIt (11.91 points) groups at the 12-month primary outcome point. However, both groups improved during the trial. Other psychological and QoL outcomes followed a similar pattern. There were no treatment group differences, but there was improvement in both groups. There was no economic evidence suggesting that BeatIt may be more cost-effective than StepUp. However, treatment costs for both groups were approximately only 4–6.5% of the total support costs. Results of the qualitative research with participants, supporters and therapists were in concert with the quantitative findings. Both treatments were perceived as active interventions and were valued in terms of their structure, content and perceived impact. Conclusions: Primary and secondary outcomes, economic data and qualitative results all clearly demonstrate that there was no evidence for BeatIt being more effective than StepUp.
Authors' methods: Design: A multicentre, single-blind, randomised controlled trial, with follow-up at 4, 8 and 12 months post randomisation. There was a nested qualitative study.
Authors' identified further reserach: Comparisons against TAU are required to determine whether or not these interventions had any effect.
Project Status: Completed
Year Published: 2018
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: England, United Kingdom
MeSH Terms
  • Adaptation, Psychological
  • Adult
  • Aggression
  • Anxiety
  • Behavior Therapy
  • Cost-Benefit Analysis
  • Depression
  • Female
  • Health Resources
  • Interpersonal Relations
  • Learning Disabilities
  • Male
  • Middle Aged
  • Quality of Life
  • Quality-Adjusted Life Years
  • Single-Blind Method
  • Social Support
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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Copyright: 2009 Queen's Printer and Controller of HMSO
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