Transdiagnostic versus Diagnosis-Specific Group Cognitive Behavioral Therapy for Anxiety Disorders and Depression: A...

Area of Science:

• Psychiatry and Mental Health
• Clinical Psychology
• Evidence-Based Practice

Background:

• The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) offers a potential avenue for widespread implementation of evidence-based psychological treatments.
• Group-based delivery of UP could enhance accessibility and scalability in mental health services.

Purpose of the Study:

• To compare the efficacy of group-delivered UP against diagnosis-specific cognitive behavioral therapy (dCBT).
• To evaluate treatment outcomes for anxiety and depression within outpatient mental health settings.

Main Methods:

• A pragmatic, multi-center, single-blinded, non-inferiority randomized controlled trial (RCT) involving 291 patients.
• Patients were assigned to either mixed-diagnosis UP or single-diagnosis dCBT groups for 14 weekly sessions.
• Primary outcome was non-inferiority on the World Health Organisation 5 Well-Being Index (WHO-5) at end-of-treatment, with secondary outcomes assessed at baseline, end-of-treatment, and 6-month follow-up.

Main Results:

• Group UP demonstrated non-inferiority to dCBT on the WHO-5 at end-of-treatment (mean difference -2.94; 95% CI -8.10 to 2.21).
• Non-inferiority for secondary outcomes (functioning and symptoms) was observed at both end-of-treatment and 6-month follow-up.
• Client satisfaction, attrition, response, remission, and deterioration rates were comparable between UP and dCBT groups.

Conclusions:

• Group-delivered UP is a non-inferior alternative to dCBT for acute-phase treatment of major depressive disorder, social anxiety disorder, panic disorder, and agoraphobia in outpatient settings.
• Further research is warranted to investigate the long-term effects of UP on well-being.
• UP presents a viable alternative to dCBT for common anxiety disorders and depression, pending replication of findings.