Monash University, Australia.
Monash University, Australia.
J Behav Ther Exp Psychiatry. 2019 Dec;65:101487. doi: 10.1016/j.jbtep.2019.101487. Epub 2019 May 22.
To assess the efficacy of a transdiagnostic cognitive behavioral therapy (tCBT) protocol for the treatment of emotional disorders with individuals that have a principal or comorbid depressive diagnosis.
Treatment-seeking adults meeting diagnostic criteria for a depressive disorder were enrolled in a 12-week tCBT open trial aimed at addressing the underlying core pathology of emotional disorders. Clinician severity ratings (CSRs) regarding principal and comorbid diagnoses, and overall severity as well as clinical global impression-severity (CGI-S) ratings were assessed at pre- and post-treatment and 4-month follow-up. Clinician's provided a clinical global impression-improvement (CGI-I) rating post-treatment and at 4-month follow-up. Depressive and anxiety symptoms were measured at pre-treatment and session-by-session using self-report measures (BDI-II and ADDQ).
Repeated measure ANOVAs indicated a reduction in principal diagnosis severity, overall severity, and CGI-S with large effects observed post-treatment (Cohen's ds = 1.29-1.92) and at 4-month follow-up (Cohen's ds = 0.77-1.04). Mixed-effect regression modelling demonstrated a decrease in depressive and anxiety symptoms over the course of treatment. CGI-I ratings identified 63.64% participants as treatment responders both post-treatment and at 4-month follow-up.
The uncontrolled nature of the trial and small sample size are the main limitations to generalizability of the findings.
The findings, although preliminary, provide additional evidence for the utilization of tCBT in the effective treatment of emotional disorders. Further research into the implementation of the tCBT for emotional disorders protocol through a randomized controlled trial involving groups of participants with a range of emotional disorder diagnoses is warranted.
评估一种跨诊断认知行为疗法(tCBT)方案治疗主要或共病抑郁诊断个体情感障碍的疗效。
符合抑郁障碍诊断标准的治疗寻求成年人参加了一项为期 12 周的 tCBT 开放试验,旨在解决情感障碍的潜在核心病理学。在治疗前、治疗后和 4 个月随访时,临床医生对主要和共病诊断以及总体严重程度和临床总体印象严重程度(CGI-S)进行了评估。临床医生在治疗后和 4 个月随访时提供了临床总体印象改善(CGI-I)评分。在治疗前和每次治疗时使用自我报告量表(BDI-II 和 ADDQ)测量抑郁和焦虑症状。
重复测量方差分析表明,主要诊断严重程度、总体严重程度和 CGI-S 在治疗后和 4 个月随访时均有显著降低,观察到较大的效应(Cohen's ds=1.29-1.92)和 4 个月随访时(Cohen's ds=0.77-1.04)。混合效应回归模型表明,治疗过程中抑郁和焦虑症状有所减轻。CGI-I 评分在治疗后和 4 个月随访时均有 63.64%的参与者被确定为治疗反应者。
试验的非控制性质和小样本量是发现普遍适用性的主要限制。
尽管初步,但这些结果提供了更多证据表明 tCBT 可有效治疗情感障碍。需要通过一项涉及一系列情感障碍诊断的参与者组的随机对照试验,进一步研究实施情感障碍的 tCBT 方案。