Pasquale Roberge1,2, Martin D Provencher3, Isabelle Gaboury1,2, Patrick Gosselin4, Helen-Maria Vasiliadis5, Annie Benoît1,2, Nathalie Carrier1,2, Martin M Antony6, Nils Chaillet7, Janie Houle8, Catherine Hudon1,2, Peter J Norton9. 1. Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke (Québec), Canada. 2. Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Sherbrooke (Québec), Canada. 3. École de psychologie, Université Laval, Sherbrooke (Québec), Canada. 4. Department of Psychology, Université de Sherbrooke, Sherbrooke (Québec), Canada. 5. Department of Community Health Sciences, Université de Sherbrooke, Québec (Québec), Canada. 6. Department of Psychology, Ryerson University, Toronto (Ontario), Canada. 7. Department of Obstetrics, Gynecology, and Reproduction, Université Laval, Québec (Québec), Canada. 8. Department of Psychology, Université du Québec à Montréal, Montréal (Québec), Canada. 9. The Cairnmillar Institute, Melbourne, Australia.
Abstract
BACKGROUND:Transdiagnostic group cognitive-behavioral therapy (tCBT) is a delivery model that could help overcome barriers to large-scale implementation of evidence-based psychotherapy for anxiety disorders. The aim of this study was to assess the effectiveness of combining group tCBT with treatment-as-usual (TAU), compared to TAU, for the treatment of anxiety disorders in community-based mental health care. METHODS: In a multicenter single-blind, two-arm pragmatic superiority randomized trial, we recruited participants aged 18-65 who met DSM-5 criteria for principal diagnoses of generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia. Group tCBT consisted of 12 weekly 2 h sessions. There were no restrictions for TAU. The primary outcome measures were the Beck Anxiety Inventory (BAI) and clinician severity rating from the Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5) for the principal anxiety disorder at post-treatment, with intention-to-treat analysis. RESULTS: A total of 231 participants were randomized to either tCBT + TAU (117) or TAU (114), with outcome data available for, respectively, 95 and 106. Results of the mixed-effects regression models showed superior improvement at post-treatment for participants in tCBT + TAU, compared to TAU, for BAI [p < 0.001; unadjusted post-treatment mean (s.d.): 13.20 (9.13) v. 20.85 (10.96), Cohen's d = 0.76] and ADIS-5 [p < 0.001; 3.27 (2.19) v. 4.93 (2.00), Cohen's d = 0.79]. CONCLUSIONS: Our findings suggest that the addition of group tCBT into usual care can reduce symptom severity in patients with anxiety disorders, and support tCBT dissemination in routine community-based care.
RCT Entities:
BACKGROUND: Transdiagnostic group cognitive-behavioral therapy (tCBT) is a delivery model that could help overcome barriers to large-scale implementation of evidence-based psychotherapy for anxiety disorders. The aim of this study was to assess the effectiveness of combining group tCBT with treatment-as-usual (TAU), compared to TAU, for the treatment of anxiety disorders in community-based mental health care. METHODS: In a multicenter single-blind, two-arm pragmatic superiority randomized trial, we recruited participants aged 18-65 who met DSM-5 criteria for principal diagnoses of generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia. Group tCBT consisted of 12 weekly 2 h sessions. There were no restrictions for TAU. The primary outcome measures were the Beck Anxiety Inventory (BAI) and clinician severity rating from the Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5) for the principal anxiety disorder at post-treatment, with intention-to-treat analysis. RESULTS: A total of 231 participants were randomized to either tCBT + TAU (117) or TAU (114), with outcome data available for, respectively, 95 and 106. Results of the mixed-effects regression models showed superior improvement at post-treatment for participants in tCBT + TAU, compared to TAU, for BAI [p < 0.001; unadjusted post-treatment mean (s.d.): 13.20 (9.13) v. 20.85 (10.96), Cohen's d = 0.76] and ADIS-5 [p < 0.001; 3.27 (2.19) v. 4.93 (2.00), Cohen's d = 0.79]. CONCLUSIONS: Our findings suggest that the addition of group tCBT into usual care can reduce symptom severity in patients with anxiety disorders, and support tCBT dissemination in routine community-based care.
Entities:
Keywords:
Anxiety disorders; community mental health services; group psychotherapy; randomized controlled trial; transdiagnostic cognitive-behaviour therapy
Authors: Pasquale Roberge; Patricia Marx; Jonathan Couture; Nathalie Carrier; Annie Benoît; Martin D Provencher; Martin M Antony; Peter J Norton Journal: BMC Psychiatry Date: 2022-06-27 Impact factor: 4.144