Christopher G Fairburn

Christopher G Fairburn
University of Oxford | OX · Department of Psychiatry

F.Med.Sci.

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381
Publications
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Publications

Publications (381)
Article
Full-text available
Background: Psychosocial interventions for adolescent mental health problems are effective, but evidence on their longer-term outcomes is scarce, especially in low-resource settings. We report on the 12-month sustained effectiveness and costs of scaling up a lay counselor-delivered, transdiagnostic problem-solving intervention for common adolescen...
Article
Full-text available
Objective Increasing the availability and accessibility of evidence‐based treatments for eating disorders is an important goal. This study investigated the effectiveness and cost‐effectiveness of guided self‐help via face‐to‐face meetings (fGSH) and a more scalable method, providing support via email (eGSH). Method A pragmatic, randomized controll...
Article
Background “POD Adventures” is a gamified mental health intervention delivered via a smartphone app and supported by counsellors for a target population of secondary school students in India. This paper describes the protocol for a pilot randomized controlled trial of a remotely delivered version of the intervention in the context of COVID-19 restr...
Preprint
BACKGROUND “POD Adventures” is a gamified mental health intervention delivered via a smartphone app and supported by counsellors for a target population of secondary school students in India. This paper describes the protocol for a pilot randomized controlled trial of a remotely delivered version of the intervention in the context of COVID-19 restr...
Article
Background No consistent first-option psychological interventions for adult outpatients with anorexia nervosa emerges from guidelines. We aimed to compare stand-alone psychological interventions for adult outpatients with anorexia nervosa with a specific focus on body-mass index, eating disorder symptoms, and all-cause dropout rate. Methods In thi...
Article
Background Training non-specialist health workers (NSHWs) at scale is a major barrier to increasing the coverage of depression care in India. This trial will test the effectiveness of two forms of digital training compared to conventional face-to-face training in changing the competence of NSHWs to deliver a brief evidence-based psychological treat...
Article
Objective This study provides the first systematic investigation of environmental exposure to putative psychosocial risk factors for eating disorders in individuals with AN and BN in Japan. It also provides a comparison of risk factors for the development of AN and BN in Japan versus the United States. Method Participants in Japan were 96 women wi...
Article
Full-text available
Objective: Understanding the mechanisms of action of psychological treatments is a key first step in refining and developing more effective treatments. The present study examined hypothesized mediators of change of enhanced cognitive behavior therapy (CBT-E) and interpersonal psychotherapy for eating disorders (IPT-ED). Method: A series of media...
Article
Full-text available
Background Mental health problems are a leading cause of disability in adolescents worldwide. Problem solving is a well-tested mental health intervention in many populations. We aimed to investigate the effectiveness of a brief, transdiagnostic problem-solving intervention for common adolescent mental health problems when delivered by non-specialis...
Article
Full-text available
Background: Conduct, anxiety, and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests the effects of a classroom-based sensitization int...
Preprint
Background Conduct, anxiety and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention for school-going adolescents with common mental health problems in India. The protocol also tests the effects of a classroom-based sensitization interv...
Article
Full-text available
Background: The PRIDE programme aims to establish a suite of transdiagnostic psychological interventions organised around a stepped care system in Indian secondary schools. This paper describes the development of a low-intensity, first-line component of the PRIDE model. Method: Contextual and global evidence informed an intervention 'blueprint'...
Article
The Healthy Activity Program (HAP), a brief, lay-counselor-delivered, behavioral activation psychological treatment, was found to be effective in reducing depressive symptoms among primary care attendees in India. We now examine whether early response predicts depression (PHQ-9) outcomes at the primary endpoint of 3 months and sustained recovery at...
Article
Full-text available
Background The current study explored the temporal pathways of change within two treatments, the Healthy Activity Program (HAP) for depression and the Counselling for Alcohol Problems (CAP) Program for harmful drinking. Methods The study took place in the context of two parallel randomized controlled trials in Goa, India. N = 50 random participant...
Preprint
Background Conduct, anxiety and depressive disorders account for over 75% of the adolescent mental health burden globally. The current protocol will test a low-intensity problem-solving intervention to improve mental health symptoms and recovery rates for school-going adolescents in India. The protocol also tests the effects of a classroom-based se...
Article
Background: Despite the global impact of bipolar disorder (BD), treatment success is limited. Challenges include syndromal and subsyndromal mood instability, comorbid anxiety, and uncertainty around mechanisms to target. The Oxford Mood Action Psychology Programme (OxMAPP) offered a novel approach within a cognitive behavioural framework, via ment...
Article
Full-text available
Background: One of the major barriers to the dissemination and implementation of psychological treatments is the scarcity of suitably trained therapists. A highly scalable form of Web-centered therapist training, undertaken without external support, has recently been shown to have promise in promoting therapist competence. Objective: The aim of...
Preprint
BACKGROUND One of the major barriers to the dissemination and implementation of psychological treatments is the scarcity of suitably trained therapists. A highly scalable form of Web-centered therapist training, undertaken without external support, has recently been shown to have promise in promoting therapist competence. OBJECTIVE The aim of this...
Article
Full-text available
Background: Recent research interest in how best to train therapists to deliver psychological treatments has highlighted the need for rigorous, but scalable, means of measuring therapist competence. There are at least two components involved in assessing therapist competence: the assessment of their knowledge of the treatment concerned, including...
Article
Full-text available
Background One of the major barriers to the dissemination and implementation of psychological treatments is the scarcity of suitably trained therapists. The currently accepted method of training is not scalable. Recently, a scalable form of training, Web-centered training, has been shown to have promise. Objective The goal of our research was to c...
Article
Although third-wave behaviour therapies are being increasingly used for the treatment of eating disorders, their efficacy is largely unknown. This systematic review and meta-analysis aimed to examine the empirical status of these therapies. Twenty-seven studies met full inclusion criteria. Only 13 randomized controlled trials (RCT) were identified,...
Article
Full-text available
Background The Healthy Activity Programme (HAP), a brief behavioural intervention delivered by lay counsellors, enhanced remission over 3 months among primary care attendees with depression in peri-urban and rural settings in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of HAP over 12 mon...
Article
Full-text available
Background Counselling for Alcohol Problems (CAP), a brief intervention delivered by lay counsellors, enhanced remission and abstinence over 3 months among male primary care attendees with harmful drinking in a setting in India. We evaluated the sustainability of the effects after treatment termination, the cost-effectiveness of CAP over 12 months,...
Data
Cost-effectiveness acceptability curve: Willingness to pay per remission achieved via counselling for alcohol problems from a health system perspective. (DOCX)
Data
Description of serious adverse events over 12 months by arm. (DOCX)
Data
Mediation results examining patient-reported readiness to change at 3 months on mean standard ethanol consumption at 12 months (n = 151). Beta estimates (β) are unstandardised. Multiple linear regression models controlled for baseline AUDIT score, baseline PHQ-9 score, where the intervention was delivered (primary health centre) and who delivered i...
Data
Interaction effect of readiness to change, expectations of treatment, and drinking severity (AUDIT score) at baseline on the effect of CAP on primary outcomes. (DOCX)
Data
Intervention effect on outcomes at 12 months (complete case analysis and random effects). 1Among those with observed data at 12 months. 2Number of participants for whom AUDIT and Alcohol Timeline Followback were available. 3Including imputed outcome data for those with missing data. 4Analysed with a zero-inflated negative binomial model that fits 2...
Data
Means and 95% CIs for key variables used in mediation analyses. (DOCX)
Data
Study protocol. The effectiveness and cost-effectiveness of lay-counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India: PREMIUM study protocol for randomised controlled trials. (PDF)
Data
Cost-effectiveness planes: CAP plus EUC compared to EUC alone per recovery achieved. (DOCX)
Data
Secondary outcomes at 12 months. (DOCX)
Data
Baseline characteristics of completers of outcome evaluation and those lost to follow-up. 1Includes those who completed the 3- and 12-month evaluations (n = 305) and those who completed only the 12-month evaluation (n = 11). 2Includes those who completed only the 3-month evaluation (n = 31) and those who dropped out before the 3-month evaluation (n...
Data
Mean costs (2015 international dollars) and QALYs gained per person over 12 months. (DOCX)
Data
Counselling for Alcohol Problems (CAP) manual. (PDF)
Data
Statistical analysis plan for the PREMIUM randomised controlled trials of the effectiveness and cost-effectiveness of lay-counsellor-delivered psychological treatments for harmful and dependent drinking and moderate to severe depression in primary care in India. (DOC)
Data
Cost-effectiveness acceptability curve: Willingness to pay per QALY gained from HAP from a health system perspective. (TIF)
Data
Cost-effectiveness planes: HAP plus EUC compared to EUC per remission achieved. (A) Health system perspective; (B) societal perspective. (TIF)
Data
Comparison of participants who were followed up and those lost to follow-up at 3 and 12 months. (DOCX)
Data
Results of t test and descriptive statistics for change in mean primary outcome score between the 3- and 12-month endpoints by trial arm (complete case n = 438). (DOCX)
Data
Interaction effect of baseline depression severity, sex, length of depression, and expectations of treatment on the effect of HAP plus EUC on scores for depression symptoms (BDI-II outcome). 1Adjusted for PHC as a fixed effect and PHQ-9 baseline score. (DOCX)
Data
Secondary outcomes at 12 months. (DOCX)
Data
Effect of HAP plus EUC on scores for depression symptoms, disability, suicide behaviour, and intimate partner violence over 9 months, based on complete case and random effects. 1Adjusted for PHC as a fixed effect and PHQ-9 baseline score. ***Not previously specified in trials protocol but specified in published analysis plan. #Suicidal thoughts ove...
Data
Statistical analysis plan. (DOC)
Data
Serious adverse events and medication use by arm in the last 3 months. (DOCX)
Data
Mediation results examining the effect of patient-reported activation levels at 3 months on 12-month depression outcomes. *Beta estimates are unstandardised. Multiple linear regression models controlled for baseline PHQ-9 score, participant age, and PHC. *p < 0.05. **p < 0.01. ***p < 0.001. c′, total effect; a × b, indirect effect. (DOCX)
Data
Mean costs (2015 international dollars) and QALYs gained per person over 12 months. (DOCX)
Article
Full-text available
Background A major barrier to the widespread dissemination of psychological treatments is the way that therapists are trained. The current method is not scalable. Objective Our objective was to conduct a proof-of-concept study of Web-centered training, a scalable online method for training therapists. Methods The Irish Health Service Executive id...
Article
Full-text available
Background: There is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy....
Article
Full-text available
The psychological treatment of mental health problems is beginning to undergo a sea-change driven by the widespread availability of digital technology. In this paper we provide an overview of the developments to date and those in the pipeline. We describe the various uses of digital interventions and consider their likely impact on clinical practic...
Article
: Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psychological treat...
Article
Full-text available
Background: Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psycholo...
Article
Full-text available
: Although structured psychological treatments are recommended as first-line interventions for depression, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of a brief psychological treatment (Healthy Activity Program [HAP]) for deli...
Article
Full-text available
Consistent predictors, and more especially moderators, of response to psychological treatments for eating disorders have not been identified. The present exploratory study examined predictors and moderators of outcome in adult patients who took part in a randomised clinical trial comparing two leading treatments for these disorders, enhanced cognit...
Article
Full-text available
BACKGROUND: Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate. AIMS: To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare. METHOD: The treatment...
Article
Objective To develop a psychotherapy rating scale to measure therapist adherence in the Strong Without Anorexia Nervosa (SWAN) study, a multi-center randomized controlled trial comparing three different psychological treatments for adults with anorexia nervosa. The three treatments under investigation were Enhanced Cognitive Behavioural Therapy (CB...
Article
Full-text available
Background Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate.AimsTo describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare.Method The treatment was de...
Article
Full-text available
Little is known about the treatment of adolescents with an eating disorder who are not underweight. Enhanced cognitive behaviour therapy (CBT-E) is a potential option as it is a treatment for adult patients with eating disorders of this type and it has been shown to be effective with adolescent patients who are underweight. The aim of the present c...
Article
Purpose of review: This article evaluates the empirical standing of online treatment (eTherapy) for people with an established eating disorder. Recent findings: There have been four randomized controlled trials of eTherapy for people with an eating disorder. All four focused on eating disorders characterized by binge eating and recruited adult p...
Article
Full-text available
Background The aim of the present study was to provide benchmark data on the duration of treatment required to restore body weight (to BMI ≥18.5 or a corresponding BMI centile) in adolescents and adults with anorexia nervosa treated with outpatient cognitive behaviour therapy. Methods Ninety-five participants (46 adolescents and 49 adults) were re...
Article
Full-text available
Eating disorders may be viewed from a transdiagnostic perspective and there is evidence supporting a transdiagnostic form of cognitive behaviour therapy (CBT-E). The aim of the present study was to compare CBT-E with interpersonal psychotherapy (IPT), a leading alternative treatment for adults with an eating disorder. One hundred and thirty patient...
Article
Background: Clinical perfectionism is a risk and maintaining factor for anxiety disorders, depression and eating disorders. Aims: The aim was to examine the psychometric properties of the 12-item Clinical Perfectionism Questionnaire (CPQ). Method: The research involved two samples. Study 1 comprised a nonclinical sample (n = 206) recruited via...
Article
Full-text available
The topic of therapist training has been relatively neglected in the research literature. Similarly, the related issue of the measurement of the outcome of training, especially therapist competence, has been largely overlooked. Data supporting the effectiveness of various methods of clinician training and those providing estimates of the level of c...