A broad internalizing dimension accounts for the genetic associations between personality and individual internalizing disorders

An interdisciplinary multimodal integrative healthcare program for depressive and anxiety disorders

Objective

Although multimodal interventions are recommended in patients with severe depressive and/or anxiety disorders, available evidence is scarce. Therefore, the current study evaluates the effectiveness of an outpatient secondary care interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, for patients with (comorbid) depressive and/or anxiety disorders.

Methods

Participants were 3,900 patients diagnosed with a depressive and/or anxiety disorder. The primary outcome was Health-Related Quality of Life (HRQoL) measured with the Research and Development-36 (RAND-36). Secondary outcomes included: (1) current psychological and physical symptoms measured with the Brief Symptom Inventory (BSI) and (2) symptoms of depression, anxiety, and stress measured with the Depression Anxiety Stress Scale (DASS). The healthcare program consisted of two active treatment phases: main 20-week program and a subsequent continuation-phase intervention (i.e., 12-month relapse prevention program). Mixed linear models were used to examine the effects of the healthcare program on primary/secondary outcomes over four time points: before start 20-week program (T0), halfway 20-week program (T1), end of 20-week program (T2) and end of 12-month relapse prevention program (T3).

Results

Results showed significant improvements from T0 to T2 for the primary variable (i.e., RAND-36) and secondary variables (i.e., BSI/DASS). During the 12-month relapse prevention program, further significant improvements were mainly observed for secondary variables (i.e., BSI/DASS) and to a lesser extent for the primary variable (i.e., RAND-36). At the end of the relapse prevention program (i.e., T3), 63% of patients achieved remission of depressive symptoms (i.e., DASS depression score ≤ 9) and 67% of patients achieved remission of anxiety symptoms (i.e., DASS anxiety score ≤ 7).

Conclusion

An interdisciplinary multimodal integrative healthcare program, delivered within a transdiagnostic framework, seems effective for patients suffering from depressive and/or anxiety disorders with regard to HRQoL and symptoms of psychopathology. As reimbursement and funding for interdisciplinary multimodal interventions in this patient group has been under pressure in recent years, this study could add important evidence by reporting on routinely collected outcome data from a large patient group. Future studies should further investigate the long-term stability of treatment outcomes after interdisciplinary multimodal interventions for patients suffering from depressive and/or anxiety disorders.

Genetic variance in conscientiousness relates to youth psychopathology beyond executive functions

Because deficits in self-regulation (SR) are core features of many diverse psychological disorders, SR may constitute one of many dimensions that underlie shared variance across diagnostic boundaries (e.g., the p factor, a dimension reflecting shared variance across multiple psychological disorders). SR definitions encompass constructs mapping onto different theoretical traditions and different measurement approaches, however. Two SR operationalizations, executive functioning and conscientiousness, are often used interchangeably despite their low empirical associations-a "jingle" fallacy that pervades much of the research on SR-psychopathology relationships. In a population-based sample of 1,219 twins and multiples from the Texas Twin Project (Mage = 10.60, SDage = 1.76), with a comprehensive battery of measures, we aimed to clarify how these often-muddled aspects of SR relate to individual differences in psychopathology, and whether links between them are accounted for by overlapping genetic and environmental factors. The p factor and an Attention Problems-specific factor were associated with lower executive functioning and conscientiousness. Executive functioning shared a small amount of genetic variance with p above and beyond conscientiousness, whereas conscientiousness shared substantial genetic variance with p independently of genetic variance accounted for by executive functioning. Conversely, the Attention Problems-specific factor was strongly genetically associated with executive functioning independently of genetic variance accounted for by conscientiousness. Results support the notion that SR and psychopathology, broadly conceived, may exist on overlapping spectra, but this overlap varies across conceptualizations of SR and the level of specificity at which psychopathology is assessed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).