Efficacy of the unified protocol for transdiagnostic cognitive-behavioral treatment for depressive and anxiety disorders: a randomized controlled trial
The efficacy of the unified protocol of the transdiagnostic treatment for emotional disorders (UP) has been poorly studied in patients with depressive disorders. This study aimed to examine the efficacy of UP for improving depressive symptoms in patients with depressive and/or anxiety-related disord...
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| Veröffentlicht in: | Psychological medicine 2023-05, Vol.53 (7), p.3009-3020 |
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| creator | Ito, Masaya Horikoshi, Masaru Kato, Noriko Oe, Yuki Fujisato, Hiroko Yamaguchi, Keiko Nakajima, Shun Miyamae, Mitsuhiro Toyota, Ayaka Okumura, Yasuyuki Takebayashi, Yoshitake |
| description | The efficacy of the unified protocol of the transdiagnostic treatment for emotional disorders (UP) has been poorly studied in patients with depressive disorders. This study aimed to examine the efficacy of UP for improving depressive symptoms in patients with depressive and/or anxiety-related disorders.
This assessor-blinded, randomized, 20-week, parallel-group, superiority study compared the efficacy of the UP with treatment-as-usual (UP-TAU)
wait-list with treatment-as-usual (WL-TAU). Patients diagnosed with depressive and/or anxiety disorders and with depressive symptoms participated. The primary outcome was depressive symptoms assessed by GRID-Hamilton depression rating scale (GRID-HAMD) at 21 weeks. The secondary outcomes included assessor-rated anxiety symptoms, severity and improvement of clinical global impression, responder and remission status, and loss of principal diagnosis.
In total, 104 patients participated and were subjected to intention-to-treat analysis [mean age = 37.4, s.d. = 11.5, 63 female (61%), 54 (51.9%) with a principal diagnosis of depressive disorders]. The mean GRID-HAMD scores in the UP-TAU and WL-TAU groups were 16.15 (s.d. = 4.90) and 17.06 (s.d. = 6.46) at baseline and 12.14 (s.d. = 5.47) and 17.34 (s.d. = 5.78) at 21 weeks, with a significant adjusted mean change difference of -3.99 (95% CI -6.10 to -1.87). Patients in the UP-TAU group showed significant superiority in anxiety and clinical global impressions. The improvement in the UP-TAU group was maintained in all outcomes at 43 weeks. No serious adverse events were observed in the UP-TAU group.
The UP is an effective approach for patients with depressive and/or anxiety disorders. |
| doi_str_mv | 10.1017/S0033291721005067 |
| format | Article |
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This assessor-blinded, randomized, 20-week, parallel-group, superiority study compared the efficacy of the UP with treatment-as-usual (UP-TAU)
wait-list with treatment-as-usual (WL-TAU). Patients diagnosed with depressive and/or anxiety disorders and with depressive symptoms participated. The primary outcome was depressive symptoms assessed by GRID-Hamilton depression rating scale (GRID-HAMD) at 21 weeks. The secondary outcomes included assessor-rated anxiety symptoms, severity and improvement of clinical global impression, responder and remission status, and loss of principal diagnosis.
In total, 104 patients participated and were subjected to intention-to-treat analysis [mean age = 37.4, s.d. = 11.5, 63 female (61%), 54 (51.9%) with a principal diagnosis of depressive disorders]. The mean GRID-HAMD scores in the UP-TAU and WL-TAU groups were 16.15 (s.d. = 4.90) and 17.06 (s.d. = 6.46) at baseline and 12.14 (s.d. = 5.47) and 17.34 (s.d. = 5.78) at 21 weeks, with a significant adjusted mean change difference of -3.99 (95% CI -6.10 to -1.87). Patients in the UP-TAU group showed significant superiority in anxiety and clinical global impressions. The improvement in the UP-TAU group was maintained in all outcomes at 43 weeks. No serious adverse events were observed in the UP-TAU group.
The UP is an effective approach for patients with depressive and/or anxiety disorders.</description><identifier>ISSN: 0033-2917</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S0033291721005067</identifier><identifier>PMID: 37449485</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adult ; Agoraphobia ; Ambulatory care ; Anxiety ; Anxiety - psychology ; Anxiety disorders ; Anxiety Disorders - diagnosis ; Anxiety Disorders - therapy ; Assessors ; Behavior modification ; Clinical trials ; Cognition ; Cognitive ability ; Cognitive behavioral therapy ; Cognitive Behavioral Therapy - methods ; Cognitive-behavioral factors ; Critical incidents ; Diagnosis ; Dominance ; Efficacy ; Emotional disorders ; Emotions ; Female ; Humans ; Impressions ; Intervention ; Medical diagnosis ; Mental depression ; Mental disorders ; Obsessive compulsive disorder ; Original ; Original Article ; Patients ; Post traumatic stress disorder ; Psychopathology ; Psychotherapy ; Remission ; Remission (Medicine) ; Treatment Outcome</subject><ispartof>Psychological medicine, 2023-05, Vol.53 (7), p.3009-3020</ispartof><rights>Copyright © The Author(s), 2022. Published by Cambridge University Press</rights><rights>Copyright © The Author(s), 2022. Published by Cambridge University Press. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2022 2022 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c539t-948abb6bf548df4269def29a11e7d47031c1b1f0568603eb3cc6d1582fb83a6e3</citedby><cites>FETCH-LOGICAL-c539t-948abb6bf548df4269def29a11e7d47031c1b1f0568603eb3cc6d1582fb83a6e3</cites><orcidid>0000-0003-2295-9733</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0033291721005067/type/journal_article$$EHTML$$P50$$Gcambridge$$Hfree_for_read</linktohtml><link.rule.ids>164,230,314,776,780,881,12825,27901,27902,30976,55603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37449485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ito, Masaya</creatorcontrib><creatorcontrib>Horikoshi, Masaru</creatorcontrib><creatorcontrib>Kato, Noriko</creatorcontrib><creatorcontrib>Oe, Yuki</creatorcontrib><creatorcontrib>Fujisato, Hiroko</creatorcontrib><creatorcontrib>Yamaguchi, Keiko</creatorcontrib><creatorcontrib>Nakajima, Shun</creatorcontrib><creatorcontrib>Miyamae, Mitsuhiro</creatorcontrib><creatorcontrib>Toyota, Ayaka</creatorcontrib><creatorcontrib>Okumura, Yasuyuki</creatorcontrib><creatorcontrib>Takebayashi, Yoshitake</creatorcontrib><title>Efficacy of the unified protocol for transdiagnostic cognitive-behavioral treatment for depressive and anxiety disorders: a randomized controlled trial</title><title>Psychological medicine</title><addtitle>Psychol. Med</addtitle><description>The efficacy of the unified protocol of the transdiagnostic treatment for emotional disorders (UP) has been poorly studied in patients with depressive disorders. This study aimed to examine the efficacy of UP for improving depressive symptoms in patients with depressive and/or anxiety-related disorders.
This assessor-blinded, randomized, 20-week, parallel-group, superiority study compared the efficacy of the UP with treatment-as-usual (UP-TAU)
wait-list with treatment-as-usual (WL-TAU). Patients diagnosed with depressive and/or anxiety disorders and with depressive symptoms participated. The primary outcome was depressive symptoms assessed by GRID-Hamilton depression rating scale (GRID-HAMD) at 21 weeks. The secondary outcomes included assessor-rated anxiety symptoms, severity and improvement of clinical global impression, responder and remission status, and loss of principal diagnosis.
In total, 104 patients participated and were subjected to intention-to-treat analysis [mean age = 37.4, s.d. = 11.5, 63 female (61%), 54 (51.9%) with a principal diagnosis of depressive disorders]. The mean GRID-HAMD scores in the UP-TAU and WL-TAU groups were 16.15 (s.d. = 4.90) and 17.06 (s.d. = 6.46) at baseline and 12.14 (s.d. = 5.47) and 17.34 (s.d. = 5.78) at 21 weeks, with a significant adjusted mean change difference of -3.99 (95% CI -6.10 to -1.87). Patients in the UP-TAU group showed significant superiority in anxiety and clinical global impressions. The improvement in the UP-TAU group was maintained in all outcomes at 43 weeks. No serious adverse events were observed in the UP-TAU group.
The UP is an effective approach for patients with depressive and/or anxiety disorders.</description><subject>Adult</subject><subject>Agoraphobia</subject><subject>Ambulatory care</subject><subject>Anxiety</subject><subject>Anxiety - psychology</subject><subject>Anxiety disorders</subject><subject>Anxiety Disorders - diagnosis</subject><subject>Anxiety Disorders - therapy</subject><subject>Assessors</subject><subject>Behavior modification</subject><subject>Clinical trials</subject><subject>Cognition</subject><subject>Cognitive ability</subject><subject>Cognitive behavioral therapy</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Cognitive-behavioral factors</subject><subject>Critical incidents</subject><subject>Diagnosis</subject><subject>Dominance</subject><subject>Efficacy</subject><subject>Emotional disorders</subject><subject>Emotions</subject><subject>Female</subject><subject>Humans</subject><subject>Impressions</subject><subject>Intervention</subject><subject>Medical diagnosis</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Obsessive compulsive disorder</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Post traumatic stress disorder</subject><subject>Psychopathology</subject><subject>Psychotherapy</subject><subject>Remission</subject><subject>Remission (Medicine)</subject><subject>Treatment Outcome</subject><issn>0033-2917</issn><issn>1469-8978</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>IKXGN</sourceid><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kc9u1DAQxi0EokvhAbggS1y4BDx24iRcUFW1gFSJA3COHHu86yqxF9tZsbwIr1svXco_cbDG0vebb-bTEPIU2Etg0L76yJgQvIeWA2MNk-09soJa9lXXt919sjrI1UE_IY9SumYMBNT8ITkRbV33ddesyPcLa51Wek-DpXmDdPHOOjR0G0MOOkzUhkhzVD4Zp9Y-pOw01WHtXXY7rEbcqJ0LUU0FQpVn9PlHi8FtxJQKQ5U35X11mPfUuBSiwZheU0WLqwmz-1bG6eBzDNNUvjk6NT0mD6yaEj451lPy-fLi0_m76urD2_fnZ1eVbkSfqxJCjaMcbVN3xtZc9gYt7xUAtqZumQANI1jWyE4ygaPQWhpoOm7HTiiJ4pS8ufXdLuOMRpf1S5ZhG92s4n4Iyg1_Kt5thnXYDcC4aGRTF4cXR4cYviyY8jC7pHGalMewpIF3ouMNsLYv6PO_0OuwRF_yFYqDaCUDWSi4pXQMKUW0d9sAGw53H_65e-l59nuMu46fhy6AOJqqeYzOrPHX7P_b3gDHdbw1</recordid><startdate>20230501</startdate><enddate>20230501</enddate><creator>Ito, Masaya</creator><creator>Horikoshi, Masaru</creator><creator>Kato, Noriko</creator><creator>Oe, Yuki</creator><creator>Fujisato, Hiroko</creator><creator>Yamaguchi, Keiko</creator><creator>Nakajima, Shun</creator><creator>Miyamae, Mitsuhiro</creator><creator>Toyota, Ayaka</creator><creator>Okumura, Yasuyuki</creator><creator>Takebayashi, Yoshitake</creator><general>Cambridge University Press</general><scope>IKXGN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7QP</scope><scope>7QR</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2295-9733</orcidid></search><sort><creationdate>20230501</creationdate><title>Efficacy of the unified protocol for transdiagnostic cognitive-behavioral treatment for depressive and anxiety disorders: a randomized controlled trial</title><author>Ito, Masaya ; Horikoshi, Masaru ; Kato, Noriko ; Oe, Yuki ; Fujisato, Hiroko ; Yamaguchi, Keiko ; Nakajima, Shun ; Miyamae, Mitsuhiro ; Toyota, Ayaka ; Okumura, Yasuyuki ; Takebayashi, Yoshitake</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c539t-948abb6bf548df4269def29a11e7d47031c1b1f0568603eb3cc6d1582fb83a6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Agoraphobia</topic><topic>Ambulatory care</topic><topic>Anxiety</topic><topic>Anxiety - psychology</topic><topic>Anxiety disorders</topic><topic>Anxiety Disorders - diagnosis</topic><topic>Anxiety Disorders - therapy</topic><topic>Assessors</topic><topic>Behavior modification</topic><topic>Clinical trials</topic><topic>Cognition</topic><topic>Cognitive ability</topic><topic>Cognitive behavioral therapy</topic><topic>Cognitive Behavioral Therapy - methods</topic><topic>Cognitive-behavioral factors</topic><topic>Critical incidents</topic><topic>Diagnosis</topic><topic>Dominance</topic><topic>Efficacy</topic><topic>Emotional disorders</topic><topic>Emotions</topic><topic>Female</topic><topic>Humans</topic><topic>Impressions</topic><topic>Intervention</topic><topic>Medical diagnosis</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Obsessive compulsive disorder</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Post traumatic stress disorder</topic><topic>Psychopathology</topic><topic>Psychotherapy</topic><topic>Remission</topic><topic>Remission (Medicine)</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ito, Masaya</creatorcontrib><creatorcontrib>Horikoshi, Masaru</creatorcontrib><creatorcontrib>Kato, Noriko</creatorcontrib><creatorcontrib>Oe, Yuki</creatorcontrib><creatorcontrib>Fujisato, Hiroko</creatorcontrib><creatorcontrib>Yamaguchi, Keiko</creatorcontrib><creatorcontrib>Nakajima, Shun</creatorcontrib><creatorcontrib>Miyamae, Mitsuhiro</creatorcontrib><creatorcontrib>Toyota, Ayaka</creatorcontrib><creatorcontrib>Okumura, Yasuyuki</creatorcontrib><creatorcontrib>Takebayashi, Yoshitake</creatorcontrib><collection>Cambridge Journals Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Psychological medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ito, Masaya</au><au>Horikoshi, Masaru</au><au>Kato, Noriko</au><au>Oe, Yuki</au><au>Fujisato, Hiroko</au><au>Yamaguchi, Keiko</au><au>Nakajima, Shun</au><au>Miyamae, Mitsuhiro</au><au>Toyota, Ayaka</au><au>Okumura, Yasuyuki</au><au>Takebayashi, Yoshitake</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of the unified protocol for transdiagnostic cognitive-behavioral treatment for depressive and anxiety disorders: a randomized controlled trial</atitle><jtitle>Psychological medicine</jtitle><addtitle>Psychol. Med</addtitle><date>2023-05-01</date><risdate>2023</risdate><volume>53</volume><issue>7</issue><spage>3009</spage><epage>3020</epage><pages>3009-3020</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><abstract>The efficacy of the unified protocol of the transdiagnostic treatment for emotional disorders (UP) has been poorly studied in patients with depressive disorders. This study aimed to examine the efficacy of UP for improving depressive symptoms in patients with depressive and/or anxiety-related disorders.
This assessor-blinded, randomized, 20-week, parallel-group, superiority study compared the efficacy of the UP with treatment-as-usual (UP-TAU)
wait-list with treatment-as-usual (WL-TAU). Patients diagnosed with depressive and/or anxiety disorders and with depressive symptoms participated. The primary outcome was depressive symptoms assessed by GRID-Hamilton depression rating scale (GRID-HAMD) at 21 weeks. The secondary outcomes included assessor-rated anxiety symptoms, severity and improvement of clinical global impression, responder and remission status, and loss of principal diagnosis.
In total, 104 patients participated and were subjected to intention-to-treat analysis [mean age = 37.4, s.d. = 11.5, 63 female (61%), 54 (51.9%) with a principal diagnosis of depressive disorders]. The mean GRID-HAMD scores in the UP-TAU and WL-TAU groups were 16.15 (s.d. = 4.90) and 17.06 (s.d. = 6.46) at baseline and 12.14 (s.d. = 5.47) and 17.34 (s.d. = 5.78) at 21 weeks, with a significant adjusted mean change difference of -3.99 (95% CI -6.10 to -1.87). Patients in the UP-TAU group showed significant superiority in anxiety and clinical global impressions. The improvement in the UP-TAU group was maintained in all outcomes at 43 weeks. No serious adverse events were observed in the UP-TAU group.
The UP is an effective approach for patients with depressive and/or anxiety disorders.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>37449485</pmid><doi>10.1017/S0033291721005067</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-2295-9733</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Cambridge University Press Journals Complete |
| subjects | Adult Agoraphobia Ambulatory care Anxiety Anxiety - psychology Anxiety disorders Anxiety Disorders - diagnosis Anxiety Disorders - therapy Assessors Behavior modification Clinical trials Cognition Cognitive ability Cognitive behavioral therapy Cognitive Behavioral Therapy - methods Cognitive-behavioral factors Critical incidents Diagnosis Dominance Efficacy Emotional disorders Emotions Female Humans Impressions Intervention Medical diagnosis Mental depression Mental disorders Obsessive compulsive disorder Original Original Article Patients Post traumatic stress disorder Psychopathology Psychotherapy Remission Remission (Medicine) Treatment Outcome |
| title | Efficacy of the unified protocol for transdiagnostic cognitive-behavioral treatment for depressive and anxiety disorders: a randomized controlled trial |
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