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《统一方案与焦虑障碍特定方案的比较:一项随机临床试验的 12 个月随访》

The Unified Protocol compared with diagnosis-specific protocols for anxiety disorders: 12-month follow-up from a randomized clinical trial.

机构信息

Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave. 2(nd) Floor, Boston, MA 02215, United States of America.

Department of Psychology, The University of Houston, Health and Biomedical Sciences Building, 4849 Calhoun Rd - Room 373, Houston, TX 77204, United States of America.

出版信息

Gen Hosp Psychiatry. 2020 Nov-Dec;67:58-61. doi: 10.1016/j.genhosppsych.2020.08.012. Epub 2020 Sep 6.

Abstract

OBJECTIVE

To examine whether the Unified Protocol (UP) remains equivalent to single-disorder protocols (SDPs) in the treatment of anxiety disorders at 12-month follow-up.

METHOD

We report results from the 12-month follow-up of a recent randomized equivalence trial [1]. Data are from 179 participants (55.31% female sex, 83.24% White, average age 30.66) who met criteria for a principal anxiety disorder and were randomized to either the UP or SDP conditions. Consistent with the parent trial, the primary outcome was principal diagnosis clinician severity rating (CSR) from the Anxiety Disorder Interview Schedule (ADIS). Secondary outcomes included anxiety, depression, and impairment. Missing data were accommodated using multiple imputation (10,000 imputed data sets) under a missing at random assumption. Equivalence between the UP and SDPs was tested using slope difference scores from latent growth models and 95% confidence interval of between-condition effect sizes.

RESULTS

The results indicated that the UP and SDP conditions remained equivalent with regard to principal diagnosis clinician severity rating at 12-month follow-up. In addition, there were no significant differences between conditions on secondary outcomes at 12-month follow-up.

CONCLUSIONS

The UP continues to yield outcomes comparable to SDPs at 12-month follow-up, and therefore provides a single intervention that can be used to treat the most commonly occurring psychiatric disorders with durable effects.

摘要

目的

检验在 12 个月随访时,统一治疗方案(UP)在治疗焦虑障碍方面是否仍然等同于单一障碍治疗方案(SDP)。

方法

我们报告了最近一项随机等效性试验的 12 个月随访结果[1]。数据来自 179 名符合主要焦虑障碍标准的参与者(55.31%为女性,83.24%为白人,平均年龄 30.66 岁),他们被随机分配到 UP 或 SDP 条件。与母试验一致,主要结局是焦虑障碍访谈量表(ADIS)的主要诊断临床严重程度评定(CSR)。次要结局包括焦虑、抑郁和损伤。缺失数据采用随机缺失假设下的 10,000 次插补处理(10,000 个插补数据集)。采用潜在增长模型的斜率差值和条件间效应大小的 95%置信区间来检验 UP 和 SDP 之间的等效性。

结果

结果表明,在 12 个月随访时,UP 和 SDP 条件在主要诊断临床严重程度评定方面仍然等效。此外,在 12 个月随访时,两组在次要结局上没有显著差异。

结论

UP 在 12 个月随访时继续产生与 SDP 可比的结果,因此提供了一种单一干预措施,可以用于治疗最常见的精神障碍,并具有持久的效果。

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