Abstract
BackgroundRates of mental health disorders are significantly greater in children with physical illnesses than in physically well children. Children with neurological conditions, such as epilepsy, are known to have particularly high rates of mental health disorders. Despite this, mental health problems in children with neurological conditions have remained under-recognised and under-treated in clinical settings. Evidence-based guided self-help interventions are efficacious in reducing symptoms of mental health disorders in children, but their efficacy in reducing symptoms of common mental health disorders in children with neurological conditions has not been investigated. We aim to pilot a guided self-help intervention for the treatment of mental health disorders in children with neurological conditions.Methods/designA pilot randomised controlled trial with 18 patients with neurological conditions and mental health disorders will be conducted. Participants attending specialist neurology clinics at a National UK Children’s Hospital will be randomised to receive guided self-help for common mental health disorders or to a 12-week waiting list control. Participants in the treatment group will receive 10 sessions of guided self-help delivered over the telephone. The waiting list control group will receive the intervention after a waiting period of 12 weeks. The primary outcome measure is reduction in symptoms of mental health disorders. Exclusion criteria are limited to those at significant risk of harm to self or others, the presence of primary mental health disorder other than anxiety, depression or disruptive behaviour (e.g. psychosis, eating disorder, obsessive-compulsive disorder) or intellectual disability at a level meaning potential participants would be unable to access the intervention. The study has ethical approval from the Camden and Islington NHS Research Ethics Committee, registration number 14.LO.1353. Results will be disseminated to patients, the wider public, clinicians and researchers through publication in journals and presentation at conferences.DiscussionThis is the first study to investigate guided self-help interventions for mental health problems in children with neurological conditions, a group which is currently under-represented in mental health research. The intervention is modular and adapted from an empirically supported cognitive behavioural treatment. The generalisability and broad inclusion criteria are strengths but may also lead to some weaknesses.Trial registrationCurrent Controlled Trials: ISRCTN21184717. Registered on 25 September 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1663-z) contains supplementary material, which is available to authorized users.
Highlights
Rates of mental health disorders are significantly greater in children with physical illnesses than in physically well children
This is the first study to investigate guided self-help interventions for mental health problems in children with neurological conditions, a group which is currently under-represented in mental health research
Children and young people with epilepsy are more likely to have autism spectrum disorder [11], attention deficit hyperactivity disorder (ADHD) [12] and intellectual disability [13], conditions which themselves are associated with a greater risk of mental health disorders [14]
Summary
This is the first study to investigate guided self-help interventions for mental health problems in children with neurological conditions — a group which is currently under-represented in mental health research. The generalisability and broad inclusion criteria are a strength but may lead to some weaknesses, including the possibility of a child not having a confirmed neurological diagnosis and no standardised measure of physical health This initial study will be based within a specialist hospital, which may limit generalisability. Chronic physical illness and mental health in children. A population survey of mental health problems in children with epilepsy. Depression and anxiety in childhood epilepsy: a review. Psychological interventions for mental health disorders in children with chronic physical illness: a systematic review. Bibliotherapy for children with anxiety disorders using written materials for parents: a randomized controlled trial. Treatment of child anxiety disorders via guided parent-delivered cognitive-behavioural therapy: randomised controlled trial.
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