Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial

被引:40
|
作者
Cano-Vindel, Antonio [1 ]
Munoz-Navarro, Roger [2 ]
Moriana, Juan A. [3 ]
Ruiz-Rodriguez, Paloma [4 ]
Adrian Medrano, Leonardo [5 ]
Gonzalez-Blanch, Cesar [6 ]
机构
[1] Univ Complutense Madrid, Fac Psychol, Campus Somosaguas S-N, Madrid 28223, Spain
[2] Univ Zaragoza, Fac Social & Human Sci, Dept Psychol & Sociol, C Cdad Escolar S-N, Teruel 44003, Spain
[3] Univ Cordoba, Dept Psychol, Maimonides Inst Res Biomed Cordoba IMIBIC, Reina Sofia Univ Hosp, Av Menendez Pidal S-N, Cordoba 14004, Spain
[4] Hlth Serv Madrid, Castilla La Nueva Primary Care Ctr, Calle Teruel 4, Madrid 28941, Spain
[5] Univ Siglo 21, Fac Psychol, Latinos 8555, RA-5008 Cordoba, Argentina
[6] Univ Hosp Marques de Valdecilla, Mental Hlth Ctr, Av Valdecilla 25, Santander 39008, Cantabria, Spain
关键词
Anxiety; depression; emotional disorders; group psychotherapy; randomized clinical trial; somatization; transdiagnostic; GENERALIZED ANXIETY DISORDER; QUALITY-OF-LIFE; PSYCHOLOGICAL INTERVENTIONS; IMPROVING ACCESS; DEPRESSION; CONSTRUCT; VALIDITY; PROGRAM; VERSION; CBT;
D O I
10.1017/S0033291720005498
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background Emotional disorders are highly prevalent in primary care. We aimed to determine whether a transdiagnostic psychological therapy plus treatment-as-usual (TAU) is more efficacious than TAU alone in primary care adult patients. Methods A randomized, two-arm, single-blind clinical trial was conducted in 22 primary care centres in Spain. A total of 1061 adult patients with emotional disorders were enrolled. The transdiagnostic protocol (n = 527) consisted of seven 90-min sessions (8-10 patients) delivered over a 12-14-week period. TAU (n = 534) consisted of regular consultations with a general practitioner. Primary outcome measures were self-reported symptoms of anxiety, depression, and somatizations. Secondary outcome measures were functioning and quality of life. Patients were assessed at baseline, post-treatment, and at 3, 6, and 12 months. Intention-to-treat and per-protocol analyses were performed. Results Post-treatment primary outcomes were significantly better in the transdiagnostic group compared to TAU (anxiety: p < 0.001; Morris's d = -0.65; depression: p < 0.001; d = -0.58, and somatic symptoms: p < 0.001; d = -0.40). These effects were sustained at the 12-month follow-up (anxiety: p < 0.001; d = -0.44; depression: p < 0.001; d = -0.36 and somatic symptoms: p < 0.001; d = -0.32). The transdiagnostic group also had significantly better outcomes on functioning (d = 0.16-0.33) and quality of life domains (d = 0.24-0.42), with sustained improvement at the 12-month follow-up in functioning (d = 0.25-0.39) and quality of life (d = 0.58-0.72). Reliable recovery rates showed large between-group effect sizes (d > 0.80) in favour of the transdiagnostic group after treatment and at the 12-month follow-up. Conclusions Adding a brief transdiagnostic psychological intervention to TAU may significantly improve outcomes in emotional disorders treated in primary care.
引用
收藏
页码:3336 / 3348
页数:13
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