When You Do Nothing, Repeated Testing Will Likely Indicate ‘Recovery’ or ‘Remission’ At Some Point

IAPT shouts eureka at this point, discharges the client and claims the improvement is due to the therapists efforts.  It is like declaring  that a person who is terminally ill is cured because they have had a good refreshing day gardening. In effect IAPT has gone fishing for flashes in the pan – I make  similar points in a forthcoming BBC Radio 4 investigation into IAPT. 

But studies of depression and the anxiety disorders  e.g Bruce et al (2005) require a 2 month period of symptoms not significantly impairing functioning (see also DSM-5 criteria for recurrence of depression). Bruce et al (2005) point out that anxiety sufferers naturally only have symptoms 80% of the time. With regards to depression Stegenga et al (2012) point out that for 40% of depression sufferers their depression naturally takes a variable course.  Without independent assessment of the period for which the person is without significant symptoms talk of remission/ recovery is meaningless. IAPT’s clients have not been assessed using this metric. 

Bruce et al (2005) https://www.dropbox.com/s/9powmto8miw60a2/Natural%20recovery%20in%20Social%20Phobia%20Panic%20Disporder%20and%20Generalised%20Anxiety%20Disorder.pdf?dl=0

 

Stegenga et al (2012) https://www.dropbox.com/s/k0x2fm0ds01no0k/natural%20course%20of%20depression%20stegenga%202012.pdf?dl=0

 

Dr Mike Scott

 

5 thoughts to “When You Do Nothing, Repeated Testing Will Likely Indicate ‘Recovery’ or ‘Remission’ At Some Point”

  1. That’s great news about the Radio 4 programme Mike. I do hope they will be discussing how MUS and LTC patients are paying the price for the IAPT service through the reductions in their physical healthcare services – mental health funding pitched against physical health funding – and how it appears that most of the MUS patients referred to IAPT will be labelled with a mental health condition (‘somatization disorder’) that they do not have.

    In the MUS arm of IAPT if two scores of the relevant MUS measure aren’t collected/present then the client’s data is entered into the standard recovery calculation instead of the MUS recovery calculation.

  2. Hopefully a paper I have co-authored with Keith Geraghty ‘ Treating Medically Unexplained Symptoms via Improving Access to Psychological Therapy (IAPT): Major Limitations Identified’ should appear before long. I did mention to Radio 4 my concerns about IAPTs expansion into MUS, but they record far more material than is broadcast so whether it finds its way into the 40 min programme I don’t know.
    Best wishes

    Mike

  3. Thanks Mike, I’ll look forward to reading your paper. Do you know roughly when the Radio 4 programme will air? I realise there’s an awful lot to discuss about IAPT, 40 minutes really isn’t enough.

Leave a Reply