Effectiveness of the implementation of transdiagnostic PsicAP-CV protocol for anxiety and depression in primary care: A Stepped Wedge Cluster Randomised Trial

IF 4.5 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders Pub Date : 2025-06-06 DOI:10.1016/j.janxdis.2025.103045

Gabriel Esteller-Collado , Virtudes Pérez-Jover , Carlos Van-der Hofstadt Román , Elisabeth Malonda-Vidal , Anna Llorca-Mestre , Maider Prieto-Vila , María Carpallo-González , César González-Blanch , Paloma Ruíz-Rodríguez , Juan Antonio Moriana , Antonio Cano-Vindel , Roger Muñoz-Navarro

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引用次数: 0

Abstract

Introduction

Anxiety and depressive disorders represent a public health challenge, with high prevalence rates and considerable impact on quality of life (QoL) and functioning. Despite evidence supporting the efficacy of transdiagnostic cognitive behavioural therapy (TD-CBT), its implementation in settings such as primary care (PC) remains limited. The aim of this paper is to analyse the results of the PsicAP-CV, a clinical trial evaluating the effectiveness and implementation of TD-CBT in the PC setting.

Methods

The study included 320 patients from the PsicAP-CV trial, a Stepped Wedge Cluster-Randomised Trial (SW-CRT). Symptoms of anxiety and depression were assessed, as well as QoL and functioning. Linear models were used to study treatment effects on outcomes and rates of recovery, reliable recovery and deterioration were calculated.

Results

findings indicate that TD-CBT is more effective than treatment-as-usual (TAU) in reducing symptoms of anxiety and depression, as well as improving QoL and functioning. In addition, although the overall reduction in symptomatology was similar between patients who received immediate treatment (EG₁) and those who received delayed treatment (EG₂), there was a trend in favour of the EG₁ group in the recovery indicators.

Discussion

these findings confirm the efficacy of TD-CBT for treating common mental disorders in PC and point to SW-CRT designs as a feasible and ethically sound avenue for implementing and scaling these evidence-based interventions within public health systems. They also support the broader integration of psychologists into PC, thus offering a scalable model that can significantly improve access to and outcomes of mental health care.

Trial registration

EURADICT 2013-001955-11/ISRCTN58437086.

查看原文本刊更多论文

在初级保健中实施跨诊断PsicAP-CV方案治疗焦虑和抑郁的有效性：一项阶梯楔形聚类随机试验

焦虑和抑郁障碍是一项公共卫生挑战，患病率高，对生活质量（QoL）和功能有重大影响。尽管有证据支持跨诊断认知行为疗法（TD-CBT）的有效性，但其在初级保健（PC）等环境中的实施仍然有限。本文的目的是分析PsicAP-CV的结果，PsicAP-CV是一项评估TD-CBT在PC环境下的有效性和实施的临床试验。方法本研究纳入320例来自PsicAP-CV试验的患者，这是一项阶梯楔形聚类随机试验（SW-CRT）。评估焦虑和抑郁症状，以及生活质量和功能。采用线性模型研究治疗对预后的影响，并计算恢复率、可靠恢复率和恶化率。结果表明，TD-CBT在减轻焦虑和抑郁症状、改善生活质量和功能方面比常规治疗（TAU）更有效。此外，尽管在接受立即治疗（EG1）和延迟治疗（EG2）的患者之间，症状的总体减少是相似的，但在恢复指标方面，有一种有利于EG1组的趋势。讨论这些发现证实了TD-CBT治疗PC患者常见精神障碍的有效性，并指出SW-CRT设计是在公共卫生系统中实施和扩展这些循证干预措施的可行和合乎道德的途径。他们还支持将心理学家更广泛地整合到个人电脑中，从而提供了一个可扩展的模型，可以显着改善获得精神卫生保健的机会和结果。试验注册号euradict 2013-001955-11/ISRCTN58437086。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Anxiety Disorders Multiple-

CiteScore

16.60

自引率

2.90%

发文量

期刊介绍： The Journal of Anxiety Disorders is an interdisciplinary journal that publishes research papers on all aspects of anxiety disorders for individuals of all age groups, including children, adolescents, adults, and the elderly. Manuscripts that focus on disorders previously classified as anxiety disorders such as obsessive-compulsive disorder and posttraumatic stress disorder, as well as the new category of illness anxiety disorder, are also within the scope of the journal. The research areas of focus include traditional, behavioral, cognitive, and biological assessment; diagnosis and classification; psychosocial and psychopharmacological treatment; genetics; epidemiology; and prevention. The journal welcomes theoretical and review articles that significantly contribute to current knowledge in the field. It is abstracted and indexed in various databases such as Elsevier, BIOBASE, PubMed/Medline, PsycINFO, BIOSIS Citation Index, BRS Data, Current Contents - Social & Behavioral Sciences, Pascal Francis, Scopus, and Google Scholar.