Long-term Effectiveness and Predictors of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy for Emotional Disorders in Specialized Care: Secondary Analysis of a Randomized Controlled Trial
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Otros documentos de la autoría: González-Robles, Alberto; Roca, Pablo; Díaz-García, Amanda; García-Palacios, Azucena; Botella, Cristina
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Título
Long-term Effectiveness and Predictors of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy for Emotional Disorders in Specialized Care: Secondary Analysis of a Randomized Controlled TrialAutoría
Fecha de publicación
2022-10-31Editor
JMIR PublicationsISSN
2368-7959Cita bibliográfica
González-Robles A, Roca P, Díaz-García A, García-Palacios A, Botella C Long-term Effectiveness and Predictors of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy for Emotional Disorders in Specialized Care: Secondary Analysis of a Randomized Controlled Trial JMIR Ment Health 2022;9(10):e40268Tipo de documento
info:eu-repo/semantics/articleVersión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
Background: Transdiagnostic internet-delivered cognitive behavioral therapy (iCBT) for emotional disorders has been shown
to be effective in specialized care in the short term. However, less is known about its long-term ... [+]
Background: Transdiagnostic internet-delivered cognitive behavioral therapy (iCBT) for emotional disorders has been shown
to be effective in specialized care in the short term. However, less is known about its long-term effects in this specific setting. In
addition, predictors of long-term effectiveness may help to identify what treatments are more suitable for certain individuals.
Objective: This study aimed to analyze the long-term effectiveness of transdiagnostic iCBT compared with that of treatment
as usual (TAU) in specialized care and explore predictors of long-term effectiveness.
Methods: Mixed models were performed to analyze the long-term effectiveness and predictors of transdiagnostic iCBT (n=99)
versus TAU (n=101) in public specialized mental health care. Outcomes included symptoms of depression and anxiety, health-related
quality of life (QoL), behavioral inhibition and behavioral activation, comorbidity, and diagnostic status (ie, loss of principal
diagnosis) from baseline to 1-year follow-up. Sociodemographic characteristics (sex, age, and education) and clinical variables
(principal diagnosis, comorbidity, and symptom severity at baseline) were selected as predictors of long-term changes.
Results: Compared with baseline, transdiagnostic iCBT was more effective than TAU in improving symptoms of depression
(b=–4.16, SE 1.80, 95% CI –7.68 to –0.67), health-related QoL (b=7.63, SE 3.41, 95% CI 1.00-14.28), diagnostic status (b=–0.24,
SE 0.09, 95% CI –1.00 to –0.15), and comorbidity at 1-year follow-up (b=–0.58, SE 0.22, 95% CI –1.00 to –0.15). From
pretreatment assessment to follow-up, anxiety symptoms improved in both transdiagnostic iCBT and TAU groups, but no
significant differences were found between the groups. Regarding the predictors of the long-term effectiveness of transdiagnostic
iCBT compared with that of TAU, higher health-related QoL at follow-up was predicted by a baseline diagnosis of anxiety, male
sex, and the use of psychiatric medication; fewer comorbid disorders at follow-up were predicted by older age and higher baseline
scores on health-related QoL; and fewer depressive symptoms at follow-up were predicted by baseline diagnosis of depression.
However, this pattern was not observed for baseline anxiety diagnoses and anxiety symptoms.
Conclusions: The results suggest that transdiagnostic iCBT is more effective than TAU to target depressive symptoms among
patients with emotional disorders. Anxiety symptoms remained stable at 1-year follow-up, with no differences between the groups.
Results on predictors suggest that some groups of patients may obtain specific gains after transdiagnostic iCBT. Specifically, and
consistent with the literature, patients with baseline depression improved their depression scores at follow-up. However, this
pattern was not found for baseline anxiety disorders. More studies on the predictor role of sociodemographic and clinical variables [-]
Publicado en
JMIR Ment Health 2022 | vol. 9 | iss. 10 | e40268Entidad financiadora
Universitat Jaume I | Ministerio de Educación, Cultura y Deporte | CIBER Fisiopatología de la Obesidad y Nutrición
Código del proyecto o subvención
P1-1B2014-43 | FPU13/00576 | CB06/03/0052
Derechos de acceso
info:eu-repo/semantics/openAccess
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Excepto si se señala otra cosa, la licencia del ítem se describe como: ©Alberto González-Robles, Pablo Roca, Amanda Díaz-García, Azucena García-Palacios, Cristina Botella. Originally published
in JMIR Mental Health (https://mental.jmir.org), 31.10.2022. This is an open-access article distributed under the terms of the
Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution,
and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The
complete bibliographic information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and
license information must be included.