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

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...

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Autores: Cano Vindel, Antonio, Muñoz-Navarro, Roger, Moriana, Juan A., Ruiz-Rodríguez, Paloma, Medrano, Leonardo Adrián, González-Blanch, César
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/7778
Acceso en línea:https://hdl.handle.net/20.500.14352/7778
Access Level:acceso abierto
Palabra clave:Anxiety
depression
emotional disorders
group psychotherapy
randomized clinical trial
somatization
transdiagnostic
Atención primaria y medicina de familia
Psiquiatría
Salud pública (Medicina)
Psicología clínica y psicodiagnóstico
Emoción y agresividad
Psicología aplicada
Psicólogos
3211 Psiquiatría
3212 Salud Pública
6101 Patología
6106.03 Emoción
6107 Psicología General
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spelling Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trialCano Vindel, AntonioMuñoz-Navarro, RogerMoriana, Juan A.Ruiz-Rodríguez, PalomaMedrano, Leonardo AdriánGonzález-Blanch, CésarAnxietydepressionemotional disordersgroup psychotherapyrandomized clinical trialsomatizationtransdiagnosticAtención primaria y medicina de familiaPsiquiatríaSalud pública (Medicina)Psicología clínica y psicodiagnósticoEmoción y agresividadPsicología aplicadaPsicólogos3211 Psiquiatría3212 Salud Pública6101 Patología6106.03 Emoción6107 Psicología GeneralBackground. 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: ISRCTN58437086Cambridge University PressUniversidad Complutense de Madrid20212021-02-0820212021-02-08journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/7778reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-SinDerivadas 3.0 Españahttps://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/77782026-06-02T12:44:21Z
dc.title.none.fl_str_mv Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
title Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
spellingShingle Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
Cano Vindel, Antonio
Anxiety
depression
emotional disorders
group psychotherapy
randomized clinical trial
somatization
transdiagnostic
Atención primaria y medicina de familia
Psiquiatría
Salud pública (Medicina)
Psicología clínica y psicodiagnóstico
Emoción y agresividad
Psicología aplicada
Psicólogos
3211 Psiquiatría
3212 Salud Pública
6101 Patología
6106.03 Emoción
6107 Psicología General
title_short Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
title_full Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
title_fullStr Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
title_full_unstemmed Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
title_sort Transdiagnostic group cognitive behavioural therapy for emotional disorders in primary care: the results of the PsicAP randomized controlled trial
dc.creator.none.fl_str_mv Cano Vindel, Antonio
Muñoz-Navarro, Roger
Moriana, Juan A.
Ruiz-Rodríguez, Paloma
Medrano, Leonardo Adrián
González-Blanch, César
author Cano Vindel, Antonio
author_facet Cano Vindel, Antonio
Muñoz-Navarro, Roger
Moriana, Juan A.
Ruiz-Rodríguez, Paloma
Medrano, Leonardo Adrián
González-Blanch, César
author_role author
author2 Muñoz-Navarro, Roger
Moriana, Juan A.
Ruiz-Rodríguez, Paloma
Medrano, Leonardo Adrián
González-Blanch, César
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv Anxiety
depression
emotional disorders
group psychotherapy
randomized clinical trial
somatization
transdiagnostic
Atención primaria y medicina de familia
Psiquiatría
Salud pública (Medicina)
Psicología clínica y psicodiagnóstico
Emoción y agresividad
Psicología aplicada
Psicólogos
3211 Psiquiatría
3212 Salud Pública
6101 Patología
6106.03 Emoción
6107 Psicología General
topic Anxiety
depression
emotional disorders
group psychotherapy
randomized clinical trial
somatization
transdiagnostic
Atención primaria y medicina de familia
Psiquiatría
Salud pública (Medicina)
Psicología clínica y psicodiagnóstico
Emoción y agresividad
Psicología aplicada
Psicólogos
3211 Psiquiatría
3212 Salud Pública
6101 Patología
6106.03 Emoción
6107 Psicología General
description 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
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-02-08
2021
2021-02-08
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/7778
url https://hdl.handle.net/20.500.14352/7778
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución-NoComercial-SinDerivadas 3.0 España
https://creativecommons.org/licenses/by-nc-nd/3.0/es/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución-NoComercial-SinDerivadas 3.0 España
https://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Cambridge University Press
publisher.none.fl_str_mv Cambridge University Press
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300724

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