Project ID iCASE2024_03_NS-MH


Co Supervisor 1A Institute of Psychiatry, Psychology & Neuroscience, School of Mental Health & Psychological Sciences, Social, Genetic & Developmental Psychiatry CentreWebsite

Co Supervisor 1B Institute of Psychiatry, Psychology & Neuroscience, School of Mental Health & Psychological Sciences, Department of Biostatistics & Health InformaticsWebsite

Additional Supervisor Dr Ana Catarino

Partner ieso

Stratifying cognitive behavioural therapy for anxiety and depression: from discovery to impact

Background: Depression and anxiety rates are rising. These debilitating disorders impact all aspects of life. Psychological therapies are more widely available than ever, but only ~50% of those treated recover. We must find ways to get people into the right form of treatment early. Most studies compare psychological therapy with medication or a wait list. However, the content of psychological therapies varies widely and different people are likely to respond to different therapeutic elements. Exploring this is difficult because usually we do not have good records of the focus of any one therapy session or treatment episode. To address this, we have partnered with ieso, the largest provider of digital mental health therapy in the UK. ieso have delivered over 650,000 hours of typed therapy, recording every interaction between patients and therapists. This de-identified dataset enables a detailed examination of symptom changes in relation to specific session content.

Opportunity: This project represents a unique opportunity, made possible by ieso, to quickly move from discovery to impact. The student will not only identify which therapeutic elements are most effective for which individuals, but will translate these findings into a stratified treatment approach that will be tested in a clinical trial.

Aims, objectives and timeline: The student will analyse data from patients with anxiety or depression treated with ieso’s usual care (year 1), or their new smartphone app (year 2). Both provide precise session content information and weekly symptom ratings. The student will identify patient characteristics or treatment features associated with improvement, then build a predictive model to maximise chance of recovery. In years 3 and 4, the student will work with ieso scientists to deliver a trial testing the clinical effectiveness of a treatment stratified to patient characteristics reflecting their predictive model.

Skills learned: Sophisticated analytical techniques, trial design, an integrated research approach in academia and industry.

Representative Publications

1. Skelton, M., Carr, E., Buckman, J. E. J., …Breen, G., & Eley, T. C. (2022). Trajectories of depression and anxiety symptom severity during psychological therapy for common mental health problems. Psychological Medicine, 1-11. doi:10.1017/S0033291722003403
2. Rayner, C., Coleman, J., Skelton, M., … Breen, G & Eley, T. C. (2022). Patient characteristics associated with retrospectively self-reported treatment outcomes following psychological therapy for anxiety or depressive disorders – a cohort of GLAD Study participants. BMC Psychiatry, 22, 719. doi: 0.1186/s12888-022-04275-6
3. Rayner, C., Coleman, J. R. I., Purves, K. L., Carr, E., Cheesman, R., Davies, M. R., Delgadillo, J., Hubel, C., Krebs, G., Peel, A. J., Skelton, M., Breen, G., & Eley, T. C. (2021). Sociodemographic factors associated with treatment-seeking and treatment receipt: Cross-sectional analysis of UK Biobank participants with lifetime generalised anxiety or major depressive disorder. BJPsych Open, 7, A7. doi: 10.1192/bjo.2021.101

1. Carr, E., Bendayan, R., Bean, D., Stammers, M., Wang, W., Zhang, H., … Dobson R. (2021). Evaluation and improvement of the National Early Warning Score (NEWS2) for COVID-19: a multi-hospital study. BMC Medicine, 19(1), 1–16. doi: 10.1186/s12916-020-01893-3
2. White, K. M., Matcham, F., Leightley, D., Carr, E., Conde, P., Dawe-Lane, E., … Hotopf, M. (2021). Exploring the Effects of In-App Components on Engagement With a Symptom-Tracking Platform Among Participants With Major Depressive Disorder (RADAR-Engage): Protocol for a 2-Armed Randomized Controlled Trial. JMIR Research Protocols, 10(12), e32653. doi: 10.2196/32653
3. Carr, E., Oetzmann, C., Davis, K., Bergin-Cartwright, G., Dorrington, S., Lavelle, G., … Hotopf, M. (2022). Trajectories of mental health among UK university staff and postgraduate students during the pandemic. Occupational and Environmental Medicine, 79(8), 514–520. doi: 10.1136/oemed-2021-108097