Consistent with the transdiagnostic hypothesis, RNT was associated with a range of anxiety disorders and depression and with comorbidity for those with a principal depressive disorder, supporting recent evidence that RNT is a transdiagnostic process. The presence of RNT, specifically worry and rumination, should be assessed and treated regardless of diagnostic profile. Future research may show that both pure and comorbid depressed or anxious patients receive incremental benefit from transdiagnostic protocols developed to treat core pathological processes of RNT traditionally associated with separate disorders.

Theory and evidence relating to biological and psychological vulnerabilities, comorbidity, latent structure, cognitive and behavioral maintaining factors, and treatment outcome suggest that commonalities across emotional disorders may outweigh the differences. Thus, researchers have recently begun evaluating transdiagnostic (or unified) treatment protocols, which target common maintaining factors, by applying them to individuals with multiple disorders or to mixeddiagnosis groups. The aim of this article is to review the efficacy of unified protocols for anxiety and mood disorders. Evidence suggests that unified treatments are associated with symptom improvement, generally perform better than wait-list controls, are associated with improvements in comorbid disorders, and may compare well to diagnosis-specific treatments. Unified protocols are also associated with high client satisfaction, therapeutic alliance, group cohesion, and positive treatment expectations. However, these conclusions are tempered by the small number of studies and methodological limitations. We propose directions for future research.

Researchers have recently suggested that the commonalities across the emotional disorders outweigh the differences, and thus similar treatment principles could be applied in unified interventions. In this study, the authors used a benchmarking strategy to investigate the transportability of cognitive-behavioral therapy (CBT) for anxiety and depression to mixed-diagnosis groups. Patients (N = 143) attended 10 2-hour sessions of group CBT plus a 1-month follow-up. Changes in anxiety and depression were indexed by effect sizes, reliable change, and clinically significant change and then benchmarked to previous efficacy and effectiveness studies. Symptoms of depression and anxiety significantly improved, and mixed-diagnosis groups compared favorably with diagnosis-specific CBT, suggesting that unified treatments are an effective, efficient, and practical method of treatment delivery.

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Many studies have examined factors influencing or associated with the outcome of bipolar disorder. However, little is known about bipolar patients' subjective experiences of their illness and the issues that are of significance to them. The use of a client-focused approach in identifying these issues is important for planning treatment and clinical medical management to address patients' specific needs. Focus group discussions and individual interviews were conducted with 18 bipolar patients and transcribed verbatim. The data were then analyzed and interpreted according to the phenomenological approach to qualitative research. The data were interpreted in terms of how patients view themselves, their lives and community, and their future. Implications for treatment and future research are discussed.