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Aguilera-Martín Á, Gálvez-Lara M, Cuadrado F, Moreno E, García-Torres F, Venceslá JF, Corpas J, Jurado-González FJ, Muñoz-Navarro R, González-Blanch C, Ruiz-Rodríguez P, Barrio-Martínez S, Prieto-Vila M, Carpallo-González M, Cano-Vindel A, Moriana JA. Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol. BMC Psychiatry 2022; 22:99. [PMID: 35139809 PMCID: PMC8826705 DOI: 10.1186/s12888-022-03726-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU). METHODS A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios. DISCUSSION This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems. TRIAL REGISTRATION ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021).
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Affiliation(s)
- Ángel Aguilera-Martín
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Mario Gálvez-Lara
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain.
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain.
| | - Fátima Cuadrado
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Eliana Moreno
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Francisco García-Torres
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - José F Venceslá
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Jorge Corpas
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Francisco J Jurado-González
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
| | - Roger Muñoz-Navarro
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, University of Valencia, Av. Blasco Ibáñez, 21, 46010, Valencia, Spain
| | - César González-Blanch
- Valdecilla Biomedical Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Spain
| | - Paloma Ruiz-Rodríguez
- Castilla La Nueva Primary Care Centre, Health Service of Madrid, C/ Teruel, 4, 28941, Fuenlabrada, Spain
| | - Sara Barrio-Martínez
- Valdecilla Biomedical Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Spain
| | - Maider Prieto-Vila
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, s/n, 28223, Madrid, Spain
| | - María Carpallo-González
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, s/n, 28223, Madrid, Spain
| | - Antonio Cano-Vindel
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, s/n, 28223, Madrid, Spain
| | - Juan A Moriana
- Department of Psychology, Faculty of Education Sciences, University of Cordoba, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
- Maimónides Biomedical Research Institute of Cordoba, Reina Sofía University Hospital, C/ San Alberto Magno, s/n, 14071, Cordoba, Spain
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Corpas J, Moriana JA, Venceslá JF, Gálvez-Lara M. Effectiveness of brief group transdiagnostic therapy for emotional disorders in primary care: A randomized controlled trial identifying predictors of outcome. Psychother Res 2021; 32:456-469. [PMID: 34269640 DOI: 10.1080/10503307.2021.1952331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
AbstractBrief transdiagnostic psychotherapy is a possible approach for emotional disorders in primary care. The objective of the present randomized controlled trial was to determine its effectiveness compared with the treatment as usual based on pharmacological interventions in patients with mild/moderate symptoms. In addition, emotional regulation strategies and cognitive factors were studied as potential predictors. Participants (N = 105) were assigned to brief group therapy based on the Unified Protocol (n = 53) or treatment as usual (n = 52). They were assessed before and after the interventions. Mean differences and stepwise regression analyses were performed. Brief group transdiagnostic psychotherapy was more effective than medication in reducing all clinical symptoms (p = .007 for generalized anxiety; p = .000 for somatization; p = .000 for panic disorder; and p = .041 for depression) and in modifying emotional regulation strategies and cognitive processes (p = .000 for cognitive reappraisal, expressive suppression, worry, rumination, and metacognition) with moderate/high effect sizes. Besides, it was found that these variables acted as predictors of the therapeutic change. It is concluded that brief therapies could be an accurate treatment for mild/moderate emotional disorders in primary care due to their cost-effective characteristics.
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Affiliation(s)
- Jorge Corpas
- Department of Psychology, University of Cordoba, Córdoba, Spain.,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Spain
| | - Juan A Moriana
- Department of Psychology, University of Cordoba, Córdoba, Spain.,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Spain
| | - Jose F Venceslá
- Department of Psychology, University of Cordoba, Córdoba, Spain.,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Spain
| | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Córdoba, Spain.,Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), Spain
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Corpas J, Moriana JA, Venceslá JF, Gálvez-Lara M. Brief psychological treatments for emotional disorders in Primary and Specialized Care: A randomized controlled trial. Int J Clin Health Psychol 2021; 21:100203. [PMID: 33363586 PMCID: PMC7753034 DOI: 10.1016/j.ijchp.2020.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background/Objective Brief transdiagnostic psychotherapies are a possible treatment for emotional disorders. We aimed to determine their efficacy on mild/moderate emotional disorders compared with treatment as usual (TAU) based on pharmacological interventions. Method: This study was a single-blinded randomized controlled trial with parallel design of three groups. Patients (N = 102) were assigned to brief individual psychotherapy (n = 34), brief group psychotherapy (n = 34) or TAU (n = 34). Participants were assessed before and after the interventions with the following measures: PHQ-15, PHQ-9, PHQ-PD, GAD-7, STAI, BDI-II, BSI-18, and SCID. We conducted per protocol and intention-to-treat analyses. Results: Brief psychotherapies were more effective than TAU for the reduction of emotional disorders symptoms and diagnoses with moderate/high effect sizes. TAU was only effective in reducing depressive symptoms. Conclusions: Brief transdiagnostic psychotherapies might be the treatment of choice for mild/moderate emotional disorders and they seem suitable to be implemented within health care systems.
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Affiliation(s)
- Jorge Corpas
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Juan A. Moriana
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Jose F. Venceslá
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
| | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), and Reina Sofia University Hospital, Cordoba, Spain
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