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

Cano-Vindel, A. ; Muñoz-Navarro, R. ; Moriana, J.A. ; Ruiz-Rodríguez, P. ; Medrano, L.A. ; González-Blanch, C.

Resumen: 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 Copyright

Idioma: Inglés

DOI: 10.1017/S0033291720005498

Año: 2022

Publicado en: Psychological Medicine 52, 15 (2022), 3336-3348
ISSN: 0033-2917

Factor impacto JCR: 6.9 (2022)

Categ. JCR: PSYCHIATRY rank: 27 / 154 = 0.175 (2022) - Q1 - T1
Categ. JCR: PSYCHOLOGY, CLINICAL rank: 10 / 131 = 0.076 (2022) - Q1 - T1
Categ. JCR: PSYCHIATRY rank: 21 / 143 = 0.147 (2022) - Q1 - T1
Categ. JCR: PSYCHOLOGY rank: 9 / 81 = 0.111 (2022) - Q1 - T1

Factor impacto CITESCORE: 13.6 - Medicine (Q1) - Psychology (Q1)

Factor impacto SCIMAGO: 2.465 - Psychiatry and Mental Health (Q1) - Applied Psychology (Q1)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Área Person.Eval.Trat.Psicoló. (Dpto. Psicología y Sociología)