NIHR | June 2019 | CBT could benefit mental health of children with long term conditions
Researchers at the University of Exeter led a systematic review which looked at the impact of cognitive behavioural therapy (CBT) on the mental health of children with long term conditions. In England, nearly a quarter (23%) of secondary school age pupils reported that they had a long-term medical illness or disability in a recent survey. Children and young people who have long term conditions are four times more likely to experience feelings of depression, anxiety and other mental health issues than those who are physically healthy.
The team of researchers identified some evidence of the benefits of CBT in inflammatory bowel disease, chronic pain and epilepsy; although the evidence in this area is limited and further research would be valuable (Source: NIHR).
Study Design: Evidence synthesis of quantitative and qualitative research.
Methods: The search strategy will be developed by an Information Specialist in consultation with topic experts, children, young people and their families. Sources will include electronic databases, citation chasing and hand-searching. Inclusion and exclusion criteria will be applied to the title and abstract of each identified citation independently by two reviewers with disagreements being settled by discussion with a third. Full text will be obtained for papers that appear to meet the criteria and a similar process used. A standardised, piloted data extraction form will be used to collect data from each included paper. Appropriate quality appraisal checklists will be used according to the study design. Quality appraisal and data extraction will be performed by one reviewer and checked by a second, with disagreements settled through discussion with a third. Synthesis methods will be determined in response to the nature of the findings but will include meta-analysis if appropriate. An overarching synthesis will bring together the findings from the two reviews through the systematic development and refinement of a conceptual framework to map out the conjectured links between the different types of intervention and anticipated outcomes, gaps in the evidence and factors that enhance or limit intervention success. Consultation with stakeholders will seek feedback on the credibility of the findings, the clarity of the framework and the extent to which it illustrates their experience.
Population: Children and young people (aged 0-25 years) with a diagnosed long term physical health conditions (LTCs) and a diagnosis of a mental health disorder (assessed by a validated and standardised measure) or at risk of such a diagnosis and experiencing symptoms of mental distress (scoring above an established cut point on a validated questionnaire).
Health Technologies: Any intervention, delivered to children and young people with the aim of reducing mental distress.
Outcomes: Outcomes describing the mental state of children and young people e.g. symptoms of depression, anxiety, emotional distress or behavioural disorders, psychological health, psychological function, suicidal behaviour, psychological aspects of health related quality of life, sleep quality and incidence of self-harm; costs and resource implications and experiences of interventions for children and young people with LTCs and mental ill health.
Timetable: The project is scheduled to take 15 months to complete, with dissemination continuing after this. Month 1-11 Conduct of systematic reviews (literature searches, study selection and retrieval, data extraction, quality appraisal, synthesis); Month 11-13 Overarching synthesis and development of conceptual framework; Month 11-12 – Report drafting; Month 13-14 – Co-creation of plain language summaries; Month 14 – Consultation with stakeholders; Month 15 – Editing.
Expertise: The team comprises a core group experienced at completing systematic reviews to deadline supplemented with people with the necessary experience of LTCs and mental ill health from a clinical perspective. Our Project Advisory Group provides additional expertise from clinical, third sector and family perspectives. In addition we will be recruiting children and young people to a C&YP Research Advisory Group.
Full details from NIHR