National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan.
Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
Psychol Med. 2023 May;53(7):3009-3020. doi: 10.1017/S0033291721005067. Epub 2022 Jan 10.
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.
统一的跨诊断情绪障碍治疗方案（UP）在抑郁障碍患者中的疗效研究甚少。本研究旨在考察 UP 改善抑郁和/或焦虑相关障碍患者抑郁症状的疗效。
这是一项盲法评估、随机、20 周、平行组、优效性研究，比较 UP 联合治疗-等候名单（UP-TAU）与治疗-等候名单（WL-TAU）治疗的疗效。参与患者为符合抑郁和/或焦虑障碍且伴有抑郁症状的患者。主要结局为 21 周时用 GRID-Hamilton 抑郁评定量表（GRID-HAMD）评估的抑郁症状。次要结局包括评定者评估的焦虑症状、临床总体印象严重程度和改善、应答者和缓解者状态以及主要诊断丧失。
共有 104 例患者参与，进行意向治疗分析[平均年龄 37.4 岁，标准差 11.5 岁，63 名女性（61%），54 名（51.9%）患者的主要诊断为抑郁障碍]。UP-TAU 和 WL-TAU 组的平均 GRID-HAMD 评分在基线时分别为 16.15（标准差 4.90）和 17.06（标准差 6.46），21 周时分别为 12.14（标准差 5.47）和 17.34（标准差 5.78），调整后的平均差值为-3.99（95%CI-6.10 至-1.87），具有统计学意义。UP-TAU 组在焦虑和临床总体印象方面表现出显著优势。在第 43 周时，UP-TAU 组的改善在所有结局中仍得以维持。UP-TAU 组未观察到严重不良事件。
UP 是一种治疗抑郁和/或焦虑相关障碍患者的有效方法。
