Introduction: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a group format could facilitate the implementation of evidence-based psychological treatments. Objective: This study compared the efficacy of group UP and diagnosis-specific cognitive behavioral therapy (dCBT) for anxiety and depression in outpatient mental health services. Methods: In this pragmatic, multi-center, single-blinded, non-inferiority, randomized controlled trial (RCT), we assigned 291 patients with major depressive disorder, social anxiety disorder, panic disorder, or agoraphobia to 14 weekly sessions in mixed-diagnosis UP or single-diagnosis dCBT groups. The primary test was non-inferiority, using a priori criteria, on the World Health Organisation 5 Well-Being Index (WHO-5) at the end of the treatment. Secondary outcomes were functioning and symptoms. We assessed outcomes at baseline, end-of-treatment, and at a 6-month follow-up. A modified per-protocol analysis was performed. Results: At end-of-treatment, WHO-5 mean scores for patients in UP (n = 148) were non-inferior to those of patients in dCBT (n = 143; mean difference –2.94; 95% CI –8.10 to 2.21). Results were inconclusive for the WHO-5 at the 6-month follow-up. Results for secondary outcomes were non-inferior at end-of-treatment and the 6-month follow-up. Client satisfaction and rates of attrition, response, remission, and deterioration were similar across conditions. Conclusions: This RCT demonstrated non-inferior acute-phase outcomes of group-delivered UP compared with dCBT for major depressive disorder, social anxiety disorder, panic disorder, and agoraphobia in outpatient mental health services. The long-term effects of UP on well-being need further investigation. If study findings are replicated, UP should be considered a viable alternative to dCBT for common anxiety disorders and depression in outpatient mental health services.
Psychother Psychosom

中文翻译：

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焦虑症和抑郁症的跨诊断与特定诊断组认知行为疗法：一项随机对照试验

简介：以小组形式提供的情绪障碍跨诊断治疗统一协议 (UP) 可以促进循证心理治疗的实施。目的：本研究比较了 UP 组和诊断特异性认知行为疗法 (dCBT) 在门诊心理健康服务中对焦虑和抑郁的疗效。方法：在这项务实、多中心、单盲、非劣效性、随机对照试验 (RCT) 中，我们将 291 名患有重度抑郁症、社交焦虑症、恐慌症或广场恐惧症的患者分配到 14 周混合诊断 UP或单诊断 dCBT 组。主要测试是在治疗结束时使用先验标准对世界卫生组织 5 福祉指数 (WHO-5) 的非劣效性。次要结果是功能和症状。我们评估了基线、治疗结束和 6 个月随访的结果。进行了修改后的符合方案分析。结果：在治疗结束时，UP 患者（n = 148）的 WHO-5 平均得分不劣于 dCBT 患者（n= 143; 平均差 –2.94；95% CI –8.10 至 2.21）。在 6 个月的随访中，WHO-5 的结果尚无定论。次要结局的结果在治疗结束和 6 个月的随访中均不劣。不同条件下的客户满意度和流失率、响应率、缓解率和恶化率相似。结论：与 dCBT 相比，本 RCT 在门诊心理健康服务中证明了在重度抑郁症、社交焦虑症、恐慌症和广场恐惧症方面，团体提供的 UP 的急性期结果非劣效。UP 对幸福感的长期影响需要进一步研究。如果研究结果被复制，UP 应该被认为是门诊心理健康服务中常见焦虑症和抑郁症的 dCBT 的可行替代方案。
心理治疗师