Information for GPs Referring to the CaPE Clinic

CaPE Clinic Info

Our project

The Care Pathway Enhancement (CaPE) clinic aims to facilitate access to mood disorder research studies in the North East of England. It is open to patients in secondary care but is particularly focused on enabling access to research for patients in primary care.

What do we offer?

The clinic accepts primary care referrals of people with mood disorders from a range of sources including, GP referrals, self-referrals via the Research+Me register or referrals via social media. The process of assessment includes taking a psychiatric history, which informs a diagnostic formulation and recommendations for a management plan, including research options.

After a brief telephone pre-screening, an appointment is offered with a psychiatry trainee who conducts the full assessment and considers suitability for ongoing studies. During the appointment, research options are considered and discussed with the patient, if appropriate.

All cases are subsequently discussed with the supervising consultant psychiatrist and with the wider multi-disciplinary CaPE clinic team, which includes consultant psychiatrists and psychiatry trainees, a consultant medical psychotherapist, mental health nurses and research assistants. The outcome of the discussion is captured in a letter which, together with a summary of the appointment, is sent to the patient and their primary care doctor.

The letter includes treatment recommendations where appropriate (pharmacological and psychotherapeutic) as well as research options, which serve as a guide to the patient and their GP.

If the patient meets research eligibility criteria and is willing to take part, they are supported to enrol in research. If not willing or eligible to take part in research, the patient is discharged from the CaPE clinic. Primary care patients enrolled in a study remain open to the CaPE clinic, in secondary care, for the study duration. The majority of studies recruited to in the clinic are NIHR funded.

Who can be referred to the CaPE clinic?

  • · Adult patients (>18 years-old)
  • · With a current or query diagnosis of:
    • o Major depressive episode
    • o Bipolar disorder
  • · No significant history of alcohol/drug abuse
  • · No significant risk to self or others. Risk manageable in primary care
  • · Please see below information on current research trials for specific study criteria

How to refer to the clinic

Please include a brief history of the patient and send it via email to: CaPE@cntw.nhs.uk

If you need further information, please do not hesitate to contact us:

Linda Davison, CaPE Clinic Coordinator: linda.davison@cntw.nhs.uk

Dr Mourad Wahba, Consultant Psychiatrist: Mourad.wahba@cntw.nhs.uk

Dr Stuart Watson, Consultant Psychiatrist: Stuart.Watson@cntw.nhs.uk

Current research trials

ASCEnD: RCT, open label, evaluating clinical and cost-effectiveness of quetiapine with aripiprazole and sertraline combination for patients with bipolar depression.

Key inclusion criteria:

  • Current bipolar disorder or query bipolar disorder- currently moderately to severely depressed (QIDS-SR >10)
  • Equipoise between quetiapine and aripiprazole/sertraline combinations. Randomisation to either arm clinically appropriate.

COMP006: RCT, double blind, comparing the efficacy, safety and tolerability of 2 administrations of study medication COMP360 (psilocybin) (25, 10 or 1mg), three weeks apart, when administered with psychological support. Participants will remain in the study for regular follow-up after the dosing sessions. Study participation is up to 62 weeks (follow-up is 49 weeks after the second dosing session)

Key inclusion criteria:

  • · Diagnosis of mod/ severe major depressive disorder
  • · Adequate trial of 2-4 anti-depressants in the current episode.
  • · Willing to stop taking all antidepressant medication prior to dosing

Key exclusion criteria:

  • · History of bipolar disorder, psychosis, or personality disorder
  • · Clinically significant risk of suicide
  • · First degree family history of schizophrenia, schizoaffective disorder, or bipolar I disorder