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

A. Eskildsen; N. Reinholt; S. van Bronswijk; R.B.K. Brund; A.B. Christensen; M. Hvenegaard; M. Arendt; A. Alrø; S. Poulsen; N.K. Rosenberg; M.J.H. Huibers; S. Arnfred

doi:10.1007/s10608-020-10116-1

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

A. Eskildsen^*
, N. Reinholt
, S. van Bronswijk
, R.B.K. Brund
, A.B. Christensen
, M. Hvenegaard
, M. Arendt
, A. Alrø
, S. Poulsen
, N.K. Rosenberg
, M.J.H. Huibers
, S. Arnfred

^*Corresponding author for this work

Aarhus University
Mental Health Services in Capital Region of Denmark
University of Copenhagen
Maastricht University
Region Zealand Mental Health Service
Vrije Universiteit Amsterdam

Research output: Contribution to journal › Article › Academic › peer-review

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.

Original language	English
Pages (from-to)	988-1001
Journal	Cognitive Therapy and Research
Volume	44
Issue number	5
DOIs	https://doi.org/10.1007/s10608-020-10116-1
Publication status	Published - 2020
Externally published	Yes

Bibliographical note

Funding Information:
The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients.

Funding Information:
The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients.

Publisher Copyright:
© 2020, The Author(s).

Funding

The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients. The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Anxiety disorders
Cognitive behaviour therapy
Major depression
Precision medicine
Unified protocol

Access to Document

10.1007/s10608-020-10116-1

Cite this

Eskildsen, A., Reinholt, N., van Bronswijk, S., Brund, R. B. K., Christensen, A. B., Hvenegaard, M., Arendt, M., Alrø, A., Poulsen, S., Rosenberg, N. K., Huibers, M. J. H., & Arnfred, S. (2020). Personalized Psychotherapy for Outpatients with Major Depression and Anxiety Disorders: Transdiagnostic Versus Diagnosis-Specific Group Cognitive Behavioural Therapy. Cognitive Therapy and Research, 44(5), 988-1001. https://doi.org/10.1007/s10608-020-10116-1

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title = "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.",

keywords = "Anxiety disorders, Cognitive behaviour therapy, Major depression, Precision medicine, Unified protocol",

author = "A. Eskildsen and N. Reinholt and \{van Bronswijk\}, S. and R.B.K. Brund and A.B. Christensen and M. Hvenegaard and M. Arendt and A. Alr{\o} and S. Poulsen and N.K. Rosenberg and M.J.H. Huibers and S. Arnfred",

note = "Funding Information: The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients. Funding Information: The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients. Publisher Copyright: {\textcopyright} 2020, The Author(s).",

year = "2020",

doi = "10.1007/s10608-020-10116-1",

language = "English",

volume = "44",

pages = "988--1001",

journal = "Cognitive Therapy and Research",

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Eskildsen, A, Reinholt, N, van Bronswijk, S, Brund, RBK, Christensen, AB, Hvenegaard, M, Arendt, M, Alrø, A, Poulsen, S, Rosenberg, NK, Huibers, MJH & Arnfred, S 2020, 'Personalized Psychotherapy for Outpatients with Major Depression and Anxiety Disorders: Transdiagnostic Versus Diagnosis-Specific Group Cognitive Behavioural Therapy', Cognitive Therapy and Research, vol. 44, no. 5, pp. 988-1001. https://doi.org/10.1007/s10608-020-10116-1

Personalized Psychotherapy for Outpatients with Major Depression and Anxiety Disorders: Transdiagnostic Versus Diagnosis-Specific Group Cognitive Behavioural Therapy. / Eskildsen, A.; Reinholt, N.; van Bronswijk, S. et al.
In: Cognitive Therapy and Research, Vol. 44, No. 5, 2020, p. 988-1001.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Personalized Psychotherapy for Outpatients with Major Depression and Anxiety Disorders

T2 - Transdiagnostic Versus Diagnosis-Specific Group Cognitive Behavioural Therapy

AU - Eskildsen, A.

AU - Reinholt, N.

AU - van Bronswijk, S.

AU - Brund, R.B.K.

AU - Christensen, A.B.

AU - Hvenegaard, M.

AU - Arendt, M.

AU - Alrø, A.

AU - Poulsen, S.

AU - Rosenberg, N.K.

AU - Huibers, M.J.H.

AU - Arnfred, S.

N1 - Funding Information: The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients. Funding Information: The study was supported by TRYGfonden (ID 114241), the Capital Region Mental Health Services, Region Zealand Mental Health Services, the Jascha Foundation, the Psychiatric Research Foundation of Central Denmark Region, the Ivan Nielsen Foundation for Individuals with Particular Mental Disorders, and the Foundation for Research on Mental Disorders. The funding sources were not involved in the study design, collection, analysis, data interpretation, writing of the paper, or the decision to submit the article for publication. We are grateful to the UP Institute, Center for Anxiety and Related Disorders (CARD), Boston University for their invaluable advice concerning the manual and group delivery and to all the participating therapists and patients. Publisher Copyright: © 2020, The Author(s).

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - Anxiety disorders

KW - Cognitive behaviour therapy

KW - Major depression

KW - Precision medicine

KW - Unified protocol

UR - https://www.scopus.com/pages/publications/85085339900

U2 - 10.1007/s10608-020-10116-1

DO - 10.1007/s10608-020-10116-1

M3 - Article

AN - SCOPUS:85085339900

SN - 0147-5916

VL - 44

SP - 988

EP - 1001

JO - Cognitive Therapy and Research

JF - Cognitive Therapy and Research

IS - 5

ER -

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

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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