Effectiveness of the internet-based Unified Protocol transdiagnostic intervention for the treatment of depression, anxiety and related disorders in a primary care setting: a randomized controlled trial.


Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
31 Aug 2022
Historique:
received: 24 01 2022
accepted: 15 07 2022
entrez: 31 8 2022
pubmed: 1 9 2022
medline: 8 9 2022
Statut: epublish

Résumé

Research has shown that internet-based cognitive behavioural therapy (iCBT) can be a very promising solution to increase access to and the dissemination of evidence-based treatments to all of the population in need. However, iCBT is still underutilized in clinical contexts, such as primary care. In order to achieve the effective implementation of these protocols, more studies in ecological settings are needed. The Unified Protocol (UP) is a transdiagnostic CBT protocol for the treatment of emotional disorders, which includes depression, anxiety and related disorders, that has shown its efficacy across different contexts and populations. An internet-based UP (iUP) programme has recently been developed as an emerging internet-based treatment for emotional disorders. However, the internet-delivered version of the UP (iUP) has not yet been examined empirically. The current project seeks to analyse the effectiveness of the iUP as a treatment for depression, anxiety and related emotional disorders in a primary care public health setting. The current study will employ a parallel-group, randomized controlled trial design. Participants will be randomly assigned to (a) the internet-based Unified Protocol (iUP), or (b) enhanced waiting list control (eWLC). Randomization will follow a 2:1 allocation ratio, with sample size calculations suggesting a required sample of 120 (iUP=80; eWLC=40). The Mini-International Neuropsychiatric Interview (M.I.N.I.) will be used for assessing potential participants. The Overall Anxiety Severity and Impairment Scale (OASIS) and the Overall Depression Severity and Impairment Scale (ODSIS) as well as other standardized questionnaires will be used for assessments at baseline, 4 weeks, 8 weeks and 12 weeks from baseline and for the iUP condition during the follow-up. Combining the advantages of a transdiagnostic treatment with an online delivery format may have the potential to significantly lower the burden of emotional disorders in public health primary care setting. Anxiety and depression, often comorbid, are the most prevalent psychological disorders in primary care. Because the iUP allows for the treatment of different disorders and comorbidity, this treatment could represent an adequate choice for patients that demand mental health care in a primary care setting. ISRCTN18056450 https://doi.org/10.1186/ISRCTN18056450 .

Sections du résumé

BACKGROUND BACKGROUND
Research has shown that internet-based cognitive behavioural therapy (iCBT) can be a very promising solution to increase access to and the dissemination of evidence-based treatments to all of the population in need. However, iCBT is still underutilized in clinical contexts, such as primary care. In order to achieve the effective implementation of these protocols, more studies in ecological settings are needed. The Unified Protocol (UP) is a transdiagnostic CBT protocol for the treatment of emotional disorders, which includes depression, anxiety and related disorders, that has shown its efficacy across different contexts and populations. An internet-based UP (iUP) programme has recently been developed as an emerging internet-based treatment for emotional disorders. However, the internet-delivered version of the UP (iUP) has not yet been examined empirically. The current project seeks to analyse the effectiveness of the iUP as a treatment for depression, anxiety and related emotional disorders in a primary care public health setting.
METHODS METHODS
The current study will employ a parallel-group, randomized controlled trial design. Participants will be randomly assigned to (a) the internet-based Unified Protocol (iUP), or (b) enhanced waiting list control (eWLC). Randomization will follow a 2:1 allocation ratio, with sample size calculations suggesting a required sample of 120 (iUP=80; eWLC=40). The Mini-International Neuropsychiatric Interview (M.I.N.I.) will be used for assessing potential participants. The Overall Anxiety Severity and Impairment Scale (OASIS) and the Overall Depression Severity and Impairment Scale (ODSIS) as well as other standardized questionnaires will be used for assessments at baseline, 4 weeks, 8 weeks and 12 weeks from baseline and for the iUP condition during the follow-up.
DISCUSSION CONCLUSIONS
Combining the advantages of a transdiagnostic treatment with an online delivery format may have the potential to significantly lower the burden of emotional disorders in public health primary care setting. Anxiety and depression, often comorbid, are the most prevalent psychological disorders in primary care. Because the iUP allows for the treatment of different disorders and comorbidity, this treatment could represent an adequate choice for patients that demand mental health care in a primary care setting.
TRIAL REGISTRATION BACKGROUND
ISRCTN18056450 https://doi.org/10.1186/ISRCTN18056450 .

Identifiants

pubmed: 36045387
doi: 10.1186/s13063-022-06551-y
pii: 10.1186/s13063-022-06551-y
pmc: PMC9429701
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

721

Informations de copyright

© 2022. The Author(s).

Références

BJPsych Open. 2021 May 03;7(3):e91
pubmed: 33938419
Clin Psychol Rev. 2021 Jul;87:101999
pubmed: 34098412
J Affect Disord. 2009 Jan;112(1-3):92-101
pubmed: 18486238
World Psychiatry. 2020 Feb;19(1):92-107
pubmed: 31922679
Psychol Assess. 2002 Dec;14(4):485-96
pubmed: 12501574
JAMA Psychiatry. 2017 Sep 1;74(9):875-884
pubmed: 28768327
Arch Gen Psychiatry. 2005 Jun;62(6):593-602
pubmed: 15939837
BMJ. 2013 Jan 08;346:e7586
pubmed: 23303884
Lancet Psychiatry. 2016 May;3(5):415-24
pubmed: 27083119
Am J Psychiatry. 1997 Nov;154(11):1571-5
pubmed: 9356566
J Psychiatr Res. 2018 Sep;104:211-216
pubmed: 30103069
Clin Psychol Rev. 2019 Aug;72:101751
pubmed: 31271848
J Med Internet Res. 2011 Dec 31;13(4):e126
pubmed: 22209829
Br J Psychiatry. 2000 Apr;176:379-86
pubmed: 10827888
Arch Intern Med. 2006 May 22;166(10):1092-7
pubmed: 16717171
J Med Internet Res. 2020 Jul 7;22(7):e18220
pubmed: 32673226
Br J Psychiatry. 2002 May;180:461-4
pubmed: 11983645
J Anxiety Disord. 2018 Apr;55:70-78
pubmed: 29422409
BMC Med. 2010 Mar 24;8:18
pubmed: 20334633
Gen Hosp Psychiatry. 2020 Nov - Dec;67:58-61
pubmed: 33011649
Can J Psychiatry. 2019 Jul;64(7):465-470
pubmed: 31096757
Ir J Psychol Med. 2020 Mar;37(1):24-31
pubmed: 30486911
Psychol Psychother. 2021 Dec;94(4):994-1014
pubmed: 33788999
Psychol Assess. 2014 Sep;26(3):815-830
pubmed: 24708078
J Clin Psychiatry. 2013 Jun;74(6):595-602
pubmed: 23842011
PLoS One. 2022 Jul 11;17(7):e0270178
pubmed: 35816479
Clin Psychol Rev. 2020 Jun;78:101852
pubmed: 32360953
Depress Anxiety. 2021 Feb;38(2):196-219
pubmed: 33225589
Depress Anxiety. 2006;23(4):245-9
pubmed: 16688739
NPJ Digit Med. 2020 Jun 15;3:85
pubmed: 32566763
Expert Rev Pharmacoecon Outcomes Res. 2018 Feb;18(1):25-41
pubmed: 29145746
JMIR Ment Health. 2018 May 24;5(2):e36
pubmed: 29798831
J Gen Intern Med. 2001 Sep;16(9):606-13
pubmed: 11556941
Am Psychol. 2010 Feb-Mar;65(2):73-84
pubmed: 20141263
Psychol Methods. 2009 Mar;14(1):43-53
pubmed: 19271847

Auteurs

Ladislav Timulak (L)

Trinity College Dublin, Dublin, Ireland. timulakl@tcd.ie.

Derek Richards (D)

Trinity College Dublin, Dublin, Ireland.
SilverCloud Science, SilverCloud Health, Dublin, Ireland.

Louise Bhandal-Griffin (L)

Trinity College Dublin, Dublin, Ireland.

Patrick Healy (P)

Trinity College Dublin, Dublin, Ireland.

Juliana Azevedo (J)

Health Service Executive, Dublin, Ireland.

Graham Connon (G)

Health Service Executive, Dublin, Ireland.

Elaine Martin (E)

Health Service Executive, Dublin, Ireland.

Aoife Kearney (A)

Health Service Executive, Dublin, Ireland.

Conor O'Kelly (C)

Health Service Executive, Dublin, Ireland.

Angel Enrique (A)

Trinity College Dublin, Dublin, Ireland.
SilverCloud Science, SilverCloud Health, Dublin, Ireland.

Nora Eilert (N)

Trinity College Dublin, Dublin, Ireland.

Sorcha O'Brien (S)

Trinity College Dublin, Dublin, Ireland.

Siobhan Harty (S)

SilverCloud Science, SilverCloud Health, Dublin, Ireland.

Alberto González-Robles (A)

University of Zaragoza, Zaragoza, Spain.

Elizabeth H Eustis (EH)

Boston University, Boston, USA.

David H Barlow (DH)

Boston University, Boston, USA.

Todd J Farchione (TJ)

Boston University, Boston, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH