Personalized Psychotherapy for Outpatients with Major Depression and Anxiety Disorders: Transdiagnostic Versus Diagnosis-Specific Group Cognitive Behavioural Therapy

Abstract

Background Only about half of all patients with anxiety disorders or major depression respond to cognitive behaviour therapy (CBT), even though this is an evidence-based treatment. Personalized treatment offers an approach to increase the number of patients who respond to therapy. The aim of this study was to examine predictors and moderators of (differential) treatment outcomes in transdiagnostic versus diagnosis-specific group CBT. Methods A sample of 291 patients from three different mental health clinics in Denmark was randomized to either transdiagnostic or diagnosis-specific group CBT. The study outcome was the regression slope of the individual patient's repeated scores on the WHO-5 Well-being Index. Pre-treatment variables were identified as moderators or predictors through a two-step variable selection approach. Results While the two-step approach failed to identify any moderators, four predictors were found: level of positive affect, duration of disorder, the detachment personality trait, and the coping strategy of cognitive reappraisal. A prognostic index was constructed, but did not seem to be robust across treatment sites. Conclusions Our findings give insufficient evidence to support a recommendation of either transdiagnostic or diagnosis-specific CBT for a given patient or to predict the response to the applied group therapies.

Cross-trial prediction in psychotherapy: External validation of the Personalized Advantage Index using machine learning in two Dutch randomized trials comparing CBT versus IPT for depression

“…The results of various PAI studies so far seem to support these hypotheses. The finding that the effects of the Freq-Mech PAI were modest and non-significant contrasts earlier findings (DeRubeis et al, 2014;Huibers et al, 2015;Webb et al, 2019;Zilcha-Mano et al, 2016), but is in line with some, most notably newer studies (Cohen et al, 2019;Delgadillo & Gonzalez Salas Duhne, 2020;Eskildsen et al, 2020;Friedl et al, 2020;Lopez-Gomez et al, 2019). Like the FreqMech dataset, the studies that had modest and non-significant findings included a high number of treatment centres and/or therapists.…”

Acceptability of and intention to use the Unified Protocol delivered in group format in the Spanish Public Health System

“…12,13 In addition, the UP can be delivered in a group format, increasing its cost-efficiency. 14,15 The transdiagnostic nature of the treatment facilitates a quick group formation, allowing clinicians to attend to a greater number of people at the same time, as a consequence, reducing the waiting lists. 16 However, in addition to the efficiency and effectiveness of the UP, other aspects such as its acceptability should be also evaluated.…”

Kölner Fragebogen zur Sprachlosigkeit

“…Aus klinischer Perspektive erfolgt die Nutzung psychologischer Testverfahren zur psychometrisch gestützten Differenzialdiagnostik, d. h. zur Differenzierung der Ausprägungsgrade der sich in Behandlung befindlichen Personen; dies ermöglicht eine zielgerichtete Intervention (Eskildsen et al 2020;Kusch und Stecker 2005;Kusch et al 2013Kusch et al , 2015Mazzocco Myers 2003). Zur Differenzierung ist die Verwendung von Schwellenwerten erforderlich, die eine entsprechende Klassifikation erlauben (Habibzadeh et al 2016;Yovanoff und Squires 2006) und es ermöglichen, Personen eine entsprechende Intervention zukommen zulassen (Jäger und Sebastian 2010).…”

“…Zur Differenzierung ist die Verwendung von Schwellenwerten erforderlich, die eine entsprechende Klassifikation erlauben (Habibzadeh et al 2016;Yovanoff und Squires 2006) und es ermöglichen, Personen eine entsprechende Intervention zukommen zulassen (Jäger und Sebastian 2010). Ergänzend gewinnen Schwellenwerte als Gegenstand komplexer Versorgungsprozesse an Bedeutung (Eskildsen et al 2020;Kusch et al 2015).…”