Association between depressive symptoms and cognitive-behavioural therapy receipt within a psychosis sample: a cross-sectional study

TY - JOUR

T1 - Association between depressive symptoms and cognitive-behavioural therapy receipt within a psychosis sample

T2 - a cross-sectional study

AU - Mason, Ava

AU - Irving, Jessica

AU - Pritchard, Megan

AU - Sanyal, Jyoti

AU - Colling, Craig

AU - Chandran, David

AU - Stewart, Robert

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

PY - 2022/5/10

Y1 - 2022/5/10

N2 - OBJECTIVES: To examine whether depressive symptoms predict receipt of cognitive-behavioural therapy for psychosis (CBTp) in individuals with psychosis. DESIGN: Retrospective cross-sectional analysis of electronic health records (EHRs) of a clinical cohort. SETTING: A secondary National Health Service mental healthcare service serving four boroughs of south London, UK. PARTICIPANTS: 20 078 patients diagnosed with an International Classification of Diseases, version 10 (ICD-10) code between F20 and 29 extracted from an EHR database. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary: Whether recorded depressive symptoms predicted CBTp session receipt, defined as at least one session of CBTp identified from structured EHR fields supplemented by a natural language processing algorithm. Secondary: Whether age, gender, ethnicity, symptom profiles (positive, negative, manic and disorganisation symptoms), a comorbid diagnosis of depression, anxiety or bipolar disorder, general CBT receipt prior to the primary psychosis diagnosis date or type of psychosis diagnosis predicted CBTp receipt. RESULTS: Of patients with a psychotic disorder, only 8.2% received CBTp. Individuals with at least one depressive symptom recorded, depression symptom severity and 12 out of 15 of the individual depressive symptoms independently predicted CBTp receipt. Female gender, White ethnicity and presence of a comorbid affective disorder or primary schizoaffective diagnosis were independently positively associated with CBTp receipt within the whole sample and the top 25% of mentioned depressive symptoms. CONCLUSIONS: Individuals with a psychotic disorder who had recorded depressive symptoms were significantly more likely to receive CBTp sessions, aligning with CBTp guidelines of managing depressive symptoms related to a psychotic experience. However, overall receipt of CBTp is low and more common in certain demographic groups, and needs to be increased.

AB - OBJECTIVES: To examine whether depressive symptoms predict receipt of cognitive-behavioural therapy for psychosis (CBTp) in individuals with psychosis. DESIGN: Retrospective cross-sectional analysis of electronic health records (EHRs) of a clinical cohort. SETTING: A secondary National Health Service mental healthcare service serving four boroughs of south London, UK. PARTICIPANTS: 20 078 patients diagnosed with an International Classification of Diseases, version 10 (ICD-10) code between F20 and 29 extracted from an EHR database. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary: Whether recorded depressive symptoms predicted CBTp session receipt, defined as at least one session of CBTp identified from structured EHR fields supplemented by a natural language processing algorithm. Secondary: Whether age, gender, ethnicity, symptom profiles (positive, negative, manic and disorganisation symptoms), a comorbid diagnosis of depression, anxiety or bipolar disorder, general CBT receipt prior to the primary psychosis diagnosis date or type of psychosis diagnosis predicted CBTp receipt. RESULTS: Of patients with a psychotic disorder, only 8.2% received CBTp. Individuals with at least one depressive symptom recorded, depression symptom severity and 12 out of 15 of the individual depressive symptoms independently predicted CBTp receipt. Female gender, White ethnicity and presence of a comorbid affective disorder or primary schizoaffective diagnosis were independently positively associated with CBTp receipt within the whole sample and the top 25% of mentioned depressive symptoms. CONCLUSIONS: Individuals with a psychotic disorder who had recorded depressive symptoms were significantly more likely to receive CBTp sessions, aligning with CBTp guidelines of managing depressive symptoms related to a psychotic experience. However, overall receipt of CBTp is low and more common in certain demographic groups, and needs to be increased.

KW - adult psychiatry

KW - depression & mood disorders

KW - health informatics

KW - psychiatry

KW - schizophrenia & psychotic disorders

UR - http://www.scopus.com/inward/record.url?scp=85129999972&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2021-051873

DO - 10.1136/bmjopen-2021-051873

M3 - Article

C2 - 35537795

AN - SCOPUS:85129999972

SN - 2044-6055

VL - 12

SP - e051873

JO - BMJ Open

JF - BMJ Open

IS - 5

ER -