Authors :
Presenting Author: Sophie Bennett, PhD DClinPsy – King's College London
J Helen Cross, PhD – UCL Great Ormond Street Institute of Child Health; Kashfia Chowdhury, MSc – University College London; Tamsin Ford, PhD – University of Cambridge; Isobel Heyman, PhD – UCL Great Ormond Street Institute of Child Health; Anna Coughtrey, PhD – UCL Great Ormond Street Institute of Child Health; Emma Dalrymple, MSc – UCL Great Ormond Street Institute of Child Health; Sarah Byford, PhD – King's College London; Bruce Chorpita, PhD – UCLA; Peter Fonagy, PhD – UCL; Rona Moss-Morris, PhD – King's College London; Colin Reilly, PhD – Young Epilepsy; jonathan Smith, PhD – Birkbeck, University of London; Terence Stephenson, MD – UCL Great Ormond Street Institute of Child Health; Sophia Varadkar, PhD – Great Ormond Street Hospital for Children; James Blackstone, MA – UCL; Harriet Quartly, BSc – UCL; Tyler Hughes, MSc – UCL Great Ormond Street Institute of Child Health; Amy Lewins, MSc – UCL Great Ormond Street Institute of Child Health; Elana Moore, MSc – UCL Great Ormond Street Institute of Child Health; Fahreen Walji, MSc – UCL Great Ormond Street Institute of Child Health; Alice Welch, MSc – UCL Great Ormond Street Institute of Child Health; Emily Whelan, MSc – UCL Great Ormond Street Institute of Child Health; Alice Zacharia, MSc – UCL Great Ormond Street Institute of Child Health; Anais D'Oelsnitz, BSc – UCL Great Ormond Street Institute of Child Health; Mariam Shah, BSc – UCL Great Ormond Street Institute of Child Health; Laila Xu, BSc – UCL Great Ormond Street Institute of Child Health; Aikaterini Vezyroglou, PhD – UCL Great Ormond Street Institute of Child Health; Kirsten Mitchell, MBBS – UCL Great Ormond Street Institute of Child Health; Isabella Nizza, PhD – Birkbeck, University of London; Poushali Ganguli, MSc – King's College London; Roz Shafran, PhD – UCL Great Ormond Street Institute of Child Health
Rationale:
Mental health difficulties are common in youth with chronic illness but many of those in need do not access evidence-based psychological treatments. This study aims to evaluate integrated mental health treatment for such youth.
Methods:
Parallel group, multicentre, open-label, randomized controlled trial of participants aged 3-18 years attending epilepsy clinics across England and Northern Ireland who met diagnostic criteria for a common mental health disorder. Participants were randomized 1:1 to receive the Mental Health Intervention for Children with Epilepsy (MICE) intervention in addition to usual care, or assessment-enhanced usual care alone (control), using an independent web-based system. The primary outcome, analyzed by intention-to-treat, was the parent-report Strengths and Difficulties Questionnaire (SDQ) at six months post-randomization. ISRCTN Trial Registration Number: 57823197 was completed.
Results:
Between August 28, 2019 and February 21, 2022, 334 participants were randomized using minimization balanced by age, primary mental health disorder, diagnosis of intellectual disability and of autistic spectrum disorder at baseline. At six months, the mean (SD) SDQ difficulties for 148 MICE patients (75 male; 73 female) was 17·6 (6·3) and for 148 control patients (73 male; 75 female), it was 19·6 (6·1). The adjusted effect of MICE was -1·7 (95% CI -2·8 to -0·5; p = 0·004; Cohen’s d 0·3). 92% of patients were followed-up at 12 months and treatment gains were maintained (adjusted effect of MICE was -2.0; p < 0.0001; Cohen’s d 0·4). Fourteen (8%) patients on the MICE arm experienced at least one serious adverse event (SAE) compared to 24 (14%) on the control arm. Sixty-eight percent of SAEs were admission due to seizures.