School of Medicine and Health Sciences, G. d'Annunzio University of Chieti-Pescara, Italy.
School of Medicine and Health Sciences, G. d'Annunzio University of Chieti-Pescara, Italy.
Clin Psychol Rev. 2021 Jul;87:101999. doi: 10.1016/j.cpr.2021.101999. Epub 2021 Mar 9.
In recent years a large array of treatment protocols conceptualized as transdiagnostic have been developed with clinical and practical advantages compared to traditional single-disorder protocols. Within this panorama, the Transdiagnostic Unified Protocol (UP) of Emotional Disorders was developed aimed at treating the negative affective processes underlying several diagnostic categories, and accounting for the covariance of different emotional disorders. The UP has been found to efficiently target the roots of these disorders leading to a reduction in symptoms of co-occurring disorders. However, several questions have marginally addressed in the previous studies, and some UP features still remain unexplored. The present meta-analysis aims at evaluating whether the UP results to significant changes in anxiety and depression symptoms severity in children, adolescents, and adults. 19 RCTs and 13 uncontrolled pre-post trials comprising 2183 patients/clients met inclusion criteria for meta-analysis. Large to moderate combined overall effect size for both depression plus anxiety were detected in the uncontrolled pre-post studies (g = 0.756) and in RTCs studies (g = 0.452), respectively. Large effect size at pre-treatment to 3-6-month follow-up was observed for combined depression plus anxiety (g = 1.113). Subgroup analysis suggested that UP treatment does not differ across the anxiety and depression self-report measures. Moreover, UP intervention outperformed both passive and active control conditions to treat negative affective syndromes. Meta-regression confirmed the moderate effects of therapist level of experience, the sample characteristics, and the UP-protocol adaptations. The findings indicate that the manualized UP treatment has potential to contribute to improving mental health outcomes, particularly of anxiety and depression.
近年来，与传统的单一疾病治疗方案相比，大量的跨诊断治疗方案已被开发出来，具有临床和实际优势。在这个全景图中，情感障碍跨诊断统一方案 (UP) 被开发出来，旨在治疗几种诊断类别的负面情感过程，并解释不同情感障碍之间的协方差。研究发现，UP 能够有效地针对这些障碍的根源，从而减少共病障碍的症状。然而，之前的研究仅略微涉及了一些问题，并且 UP 的一些特征仍未得到探索。本荟萃分析旨在评估 UP 是否会导致儿童、青少年和成人的焦虑和抑郁症状严重程度发生显著变化。19 项 RCT 和 13 项无对照前后研究共纳入 2183 名患者/来访者，符合荟萃分析的纳入标准。无对照前后研究（g=0.756）和 RCT 研究（g=0.452）中均检测到抑郁加焦虑的总体效应量较大。在治疗前到 3-6 个月随访期间，联合抑郁加焦虑的效应量较大（g=1.113）。亚组分析表明，UP 治疗在焦虑和抑郁自评量表上没有差异。此外，UP 干预在治疗负面情感综合征方面优于被动和主动对照组。元回归证实了治疗师经验水平、样本特征和 UP 方案适应性的中等影响。研究结果表明，UP 治疗方案具有改善心理健康结果的潜力，特别是在焦虑和抑郁方面。
