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

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Cano Vindel, Antonio and Muñoz-Navarro, Roger and Moriana, Juan A. and Ruiz-Rodríguez, Paloma and Medrano, Leonardo Adrián and González-Blanch, César (2021) Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial. Psychological Medicine . pp. 1-13. ISSN 0033-2917

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Official URL: https://doi.org/10.1017/S0033291720005498



Abstract

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.

Trial Registration, isrctn.org identifier: ISRCTN58437086


Item Type:Article
Uncontrolled Keywords:Anxiety, depression, emotional disorders, group psychotherapy, randomized clinical trial, somatization, transdiagnostic
Subjects:Medical sciences > Medicine > Primary health care and Family medicine
Medical sciences > Medicine > Psychiatry
Medical sciences > Medicine > Public health
Medical sciences > Psychology > Clinical psychology and psychodiagnostics
Medical sciences > Psychology > Emotions and Aggresiveness
Medical sciences > Psychology > Applied psychology
Medical sciences > Psychology > Psychologists
ID Code:63902
Deposited On:12 Feb 2021 11:29
Last Modified:12 Feb 2021 11:29

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