Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial

Journal of Anxiety Disorders

Volumn 35, Issue , 2015, Pages 88-102

  Titov, N ^a   Dear, B F ^a   Staples, L G ^a   Terides, M D ^a   Karin, E ^a   Sheehan, J ^a   Johnston, L ^a   Gandy, M ^a   Fogliati, V J ^a   Wootton, B M ^a,b   McEvoy, P M ^c  

^a MACQUARIE UNIVERSITY   (Australia)

^b UNIVERSITY OF TASMANIA   (Australia)

^c CURTIN UNIVERSITY   (Australia)

Author keywords

24 month follow up; Anxiety disorders; Disorder specific; Internet; Major depressive disorder; Randomized controlled trial; Self guided; Therapist guided; Transdiagnostic; Treatment

Indexed keywords

ADULT; ANXIETY DISORDER; ARTICLE; CLINICAL EFFECTIVENESS; COGNITIVE THERAPY; COMORBIDITY; CONTROLLED STUDY; DISABILITY; DISORDER SPECIFIC COGNITIVE BEHAVIOR THERAPY; DISTRESS SYNDROME; FEMALE; GENERALIZED ANXIETY DISORDER; HUMAN; MAJOR CLINICAL STUDY; MAJOR DEPRESSION; MALE; NEUROSIS; PANIC; PATIENT SATISFACTION; RANDOMIZED CONTROLLED TRIAL; SOCIAL PHOBIA; TRANSDIAGNOSTIC COGNITIVE BEHAVIOR THERAPY; TREATMENT DURATION; TREATMENT RESPONSE; TREATMENT WITHDRAWAL; ADOLESCENT; ANXIETY DISORDERS; CLINICAL TRIAL; COMPARATIVE STUDY; COMPLICATION; DEPRESSIVE DISORDER, MAJOR; INTERNET; MIDDLE AGED; MULTICENTER STUDY; PANIC DISORDER; PHOBIC DISORDERS; PROCEDURES; SELF CARE; TELECONSULTATION; TREATMENT OUTCOME; YOUNG ADULT;

ADOLESCENT; ADULT; ANXIETY DISORDERS; COGNITIVE THERAPY; DEPRESSIVE DISORDER, MAJOR; FEMALE; HUMANS; INTERNET; MALE; MIDDLE AGED; PANIC DISORDER; PATIENT SATISFACTION; PHOBIC DISORDERS; REMOTE CONSULTATION; SELF CARE; TREATMENT OUTCOME; YOUNG ADULT;

EID: 84942585020     PISSN: 08876185     EISSN: 18737897     Source Type: Journal    
DOI: 10.1016/j.janxdis.2015.08.002     Document Type: Article

References (78)

1. Andersson G., Hedman E. Effectiveness of guided Internet-based cognitive behavior therapy in regular clinical settings. Verhaltenstherapie 2013, 23(3):140-148.
2. Andersson G., Titov N. Advantages and limitations of Internet-based interventions for common mental disorders. World Psychiatry 2014, 13:4-11.
3. Andrews G., Cuijpers P., Craske M.G., McEvoy P., Titov N. Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis. PLoS One 2010, 5(10):e13196.
4. Andrews G., Slade T. Interpreting scores on the Kessler psychological distress scale (K10). Australian and New Zealand Journal of Public Health 2001, 25(6):494-497.
5. Andrews G., Slade T., Issakidis C. Deconstructing current Comorbidity: Data from the Australian National Survey of Mental Health and Wellbeing. British Journal of Psychiatry 2002, 10.1192/bjp.181.4.306.
6. Barlow D.H., Allen L.B., Choate M.L. Toward a unified treatment for emotional disorders. Behavior Therapy 2004, 35:205-230.
7. Berger T., Caspar F., Richardson R., Kneubuhler B., Sutter D., Andersson G. Internet-based treatment of social phobia: A randomised controlled trial comparing unguided with two types of guided self-help. Behaviour Research and Therapy 2011, 49(3):158-169.
8. Berger T., Hämmerli K., Gubser N., Caspar F. Internet-based treatment of depression: A randomised controlled trial comparing guided with unguided self-help. Behaviour Research and Therapy 2011, 40:251-266.
9. Brown T.A., Antony M.M., Barlow D.H. Diagnostic comorbidity in panic disorder: Effect on treatment outcome and course of comorbid diagnoses following treatment. Journal of Consulting and Clinical Psychology 1995, 63(3):408.
10. Burgess P.M., Prikis J.A., Slade T., Johnston A., Meadows G.M., Gunn J.M. Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Australian & New Zealand Journal of Psychiatry 2007, 43(7):615-623.
11. Butler A.C., Chapman J.E., Forman E.M., Beck A.T. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review 2006, 26(1):17-31.
12. Carlbring P., Maurin L., Törngren C., Linna E., Eriksson T., Sparthan E., Strååt M., Marquez von Hage C., Bergman-Nordgren L., Andersson G. Individually-tailored, Internet-based treatment for anxiety disorders: a randomized controlled trial. Behaviour Research and Therapy 2011, 49(1):18-24.
13. Christensen H., Griffiths K.M., Mackinnon A.J., Brittliffe K. Online randomized controlled trial of brief and full cognitive behaviour therapy for depression. Psychological Medicine 2006, 36:1737-1746.
14. Clark D. Cognitive behavioral therapy for anxiety and depression: possibilities and limitations of a transdiagnostic perspective. Cognitive Behaviour Therapy 2009, 38(Supp. 1):29-34.
15. Clark L., Watson D., Mineka S. Temperament, personality, and the mood and anxiety disorders. Journal of Abnormal Psychology 1994, 103(1):103-116.
16. Connor K.M., Kobak K.A., Churchill L.E., Katzelnick D., Davidson J.R. Mini-SPIN: A brief screening assessment for generalized social anxiety disorder. Depression and Anxiety 2001, 14(2):137-140.
17. Costa P.T., McCrae R. The NEO personality inventory manual 1985, Psychological Assessment Resources, Odessa, FL.
18. Craske M.G., Farchione T.J., Allen L.B., Barrios V., Stoyanova M., Rose R. Cognitive behavioral therapy for panic disorder and comorbidity: more of the same or less of more?. Behaviour Research and Therapy 2007, 45(6):1095-1109.
19. Craske M.G., Roy-Byrne P.P., Stein M.B., Sullivan G., Sherbourne C., Bystritsky A. Treatment for anxiety disorders: Efficacy to effectiveness to implementation. Behaviour Research and Therapy 2009, 47(11):931-937.
20. Cuijpers P., Smit F., Penninx B.W., de Graaf R., ten Have M., Beekman A.T. Economic costs of neuroticism: a population-based study. Archives of General Psychiatry 2010, 67(10):1086-1093.
21. Cuijpers P., van Straten A., Andersson G., van Oppen P. Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology 2008, 76(6):909-922.
22. Cuijpers P., van Straten A., Donker M. Personality traits of patients with mood and anxiety disorders. Psychiatry Research 2005, 133(2):229-237.
23. Dear B.F., Gandy M., Karin E., Staples L.G., Johnston L., Fogliati V.J., Wootton B.M., Terides M.D., Kayrouz R., Nicholson Perry K., Sharpe L., Nicholas M.K., Titov N. The Pain Course: a randomised controlled trial examining an internet delivered pain management program when provided with different levels of clinician support. Pain. 2015, 156:1920-1935.
24. Dear B.F., Staples L.G., Terides M.D., Karin E., Zou J., Johnston L., Gandy M., Fogliati V.J., Wootton B.M., McEvoy P., Titov N. Evaluating transdiagnostic versus disorder-specific and clinician-guided versus self-guided treatment for generalized anxiety disorder (GAD): a randomized controlled trial. Journal of Anxiety Disorders 2015, (in press).
25. Dear B.F., Titov N., Schwencke G., Andrews G., Johnston L., Craske M.G., McEvoy P. An open trial of a brief transdiagnostic internet treatment for anxiety and depression. Behaviour Research and Therapy 2011, 49(12):830-837.
26. Dear B.F., Titov N., Sunderland M., McMillan D., Anderson T., Lorian C., Robinson E. Psychometric Comparison of the Generalized Anxiety Disorder Scale-7 and the Penn State Worry Questionnaire for Measuring Response during Treatment of Generalised Anxiety Disorder. Cognitive Behaviour Therapy 2011, 40(3):216-227.
27. Dear B.F., Zou J.B., Ali S., Lorian C.N., Johnston L., Sheehan J., Staples L.G., Gandy M., Fogliati V.J., Klein B., Titov N. Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior therapy for older adults with symptoms of anxiety: a randomized controlled trial. Behavior Therapy 2015, 46(2):206-217.
28. Farchione T.J., Fairholme C.P., Ellard K.K., Boisseau C.L., Thompson-Hollands J., Carl J.R., Gallagher M.W., Barlow D.H. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior Therapy 2012, 43(3):666-678.
29. Goldberg, D. (2010). Should our major classifications of mental disorders be revised?
30. Griffith J.W., Zinbarg R.E., Craske M.G., Mineka S., Rose R.D., Waters A.M., Sutton J.M. Neuroticism as a common dimension in the internalizing disorders. Psychological Medicine 2010, 40:1125-1136.
31. Houck P.R., Spiegel D.A., Shear M.K., Rucci P. Reliability of the self-report version of the Panic Disorder Severity Scale. Depression and Anxiety 2002, 15(4):183-185.
32. Hubbarb A., Ahern J., Fleisher N., Vean Der Laan M., Lippman S., Jewell N., Cruckner T., Satariano W. To GEE or not to GEE: comparing population average and mixed models for estimating the associations between neighborhood risk factors and health. Epidemiology 2010, 21:467-474.
33. Johansson R., Andersson G. Internet-based psychological treatments for depression. Expert Review of Neurotherapeutics 2012, 12:861-870.
34. Johansson R., Lyssarides C., Andersson G., Rousseau A. Personality change after Internet-delivered cognitive behavior therapy for depression. PeerJ 2013, 1:e39.
35. Johansson R., Sjöberg E., Sjögren M., Johnsson E., Carlbring P., Andersson T., Rousseau A., Andersson G. Tailored vs. standardized internet-based cognitive behavior therapy for depression and comorbid symptoms: a randomized controlled trial. PLoS One 2012, 7(5):e36905.
36. Johnston L., Titov N., Andrews G., Dear B.F., Spence J. Comorbidity and internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders. Cognitive Behaviour Therapy 2013, 4(4).
37. Johnston L., Titov N., Andrews G., Spence J., Dear B.F. A RCT of a transdiagnostic internet-delivered treatment for three anxiety disorders: examination of support roles and disorder-specific outcomes. PLoS One 2011, 6(11):e28079.
38. Kessler R.C., Aguilar-Gaxiola S., Alonso J., Chatterji S., Lee S., Ormel J., Üstün T.B., Wang P.S. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. Epidemiologia e Psichiatria Sociale 2009, 18(01):23-33.
39. Kessler R.C., Andrews G., Colpe L.J., Hiripi E., Mroczek D.K., Normand S.-L., Walters E.E., Zaslavsky A.M. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine 2002, 32(06):959-976.
40. Klein B., Meyer D., Austin D.W., Kyrios M. Anxiety online-a virtual clinic: preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms. Journal of Medical Internet Research 2011, 13(4):e89.
41. Kroenke K., Spitzer R.L., Williams J.B. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 2001, 16(9):606-613.
42. Kroenke K., Spitzer R.L., Williams J.B., Lowe B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. General Hospital Psychiatry 2010, 32(4):345-359.
43. Lahey B.B. Public health significance of neuroticism. American Psychologist 2009, 64(4):241.
44. Lecrubier Y., Sheehan D., Weiller E., Amorim P., Bonora I., Harnett Sheehan K., Janavs J., Dunbar G. The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European psychiatry 1997, 12(5):224-231.
45. Leon A.C., Olfson M., Portera L., Farber L., Sheehan D.V. Assessing psychiatric impairment in primary care with the Sheehan Disability Scale. The International Journal of Psychiatry in Medicine 1997, 27(2):93-105.
46. Löwe B., Decker O., Müller S., Brähler E., Schellberg D., Herzog W., Herzberg P.Y. Validation and standardization of the generalized anxiety disorder screener (GAD-7) in the general population. Medical Care 2008, 46(3):266-274.
47. Mansell W., Harvey A., Watkins E., Shafran R. Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy 2009, 23(1):6-19.
48. McEvoy P.M., Nathan P., Norton P.J. Efficacy of transdiagnostic treatments: a review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy 2009, 23(1):20-33.
49. Meyer B., Berger T., Caspar F., Beevers C.G., Andersson G., Weiss M. Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial. Journal of Medical Internet Research 2009, 11(2).
50. Meyer B., Bierbrodt J., Schröder J., Berger T., Beevers C.G., Weiss M., Jacob G., Späth C., Andersson G., Lutz W., Hautzinger M., Löwe B., Rose M., Hohagen F., Caspar F., Greiner W., Moritz S., Klein J.P. Effects of an Internet intervention (Deprexis) on severe depression symptoms: Randomized controlled trial. Internet Interventions 2015, 2(1):48-59.
51. Murray L.K., Dorsey S., Haroz E., Lee C., Alsiary M.M., Haydary A., Weiss W.M., Bolton P. A common elements treatment approach for adult mental health problems in low-and middle-income countries. Cognitive and Behavioral Practice 2014, 212:111-123.
52. Norton P.J., Barrera T.L. Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: a preliminary randomized controlled noninferiority trial. Depression and Anxiety 2012, 29(10):874-882.
53. Norton P.J., Temple S.R., Petit J.W. Suicidal ideation and anxiety disorders: elevated risk or artifact of comorbid depression?. Journal of Behavior Therapy and Experimental Psychiatry 2008, 39(4):515-525.
54. Osório F.d.L., Crippa J.A.S., Loureiro S.R. Further study of the psychometric qualities of a brief screening tool for social phobia (MINI-SPIN) applied to clinical and nonclinical samples. Perspectives in Psychiatric Care 2010, 46(4):266-278.
55. Reinholt N., Krogh J. Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: a systematic review and meta-analysis of published outcome studies. Cognitive Behaviour Therapy 2014, 43(3):171-184.
56. Richards D., Richardson T. Computer-based psychological treatments for depression: a systematic review and meta-analysis. Clinical Psychology Review 2012, 32(4):329-342.
57. Robinson E., Titov N., Andrews G., McIntyre K., Schwencke G., Solley K. Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance. PLoS One 2010, 5(6):e10942.
58. Sheehan D.V. The anxiety disease 1983, Scribner, New York.
59. Spinhoven P., de Rooij M., Heiser W., Smit J.H., Penninx B.W. The role of personality in comorbidity among anxiety and depressive disorders in primary care and specialty care: a cross-sectional analysis. General Hospital Psychiatry 2009, 31(5):470-477.
60. Spitzer R.L., Kroenke K., Williams J.B., Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine 2006, 166(10):1092-1097.
61. Stewart R.E., Chambless D.L. Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: a meta-analysis of effectiveness studies. Journal of Consulting and Clinical Psychology 2009, 77(4):595.
62. Talkovsky A.M., Norton P.J. Mediators of transdiagnostic group cognitive behavior therapy. Journal of Anxiety Disorders 2014, 28:919-924.
63. Titov N., Andrews G., Davies M., McIntyre K., Robinson E., Solley K. Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance. PLoS One 2010, 5(6):e10939.
64. Titov N., Andrews G., Kemp A., Robinson E. Characteristics of adults with anxiety or depression treated at an internet clinic: comparison with a national survey and an outpatient clinic. PLoS One 2010, 5(5):e10885.
65. Titov N., Dear B., Johnston L., Terides M.D. Transdiagnostic internet treatment for anxiety and depression. Spanish Journal of Clinical Psychology 2012, 17(3):237-260.
66. Titov N., Dear B., Staples L.G., Bennett-Levy J., Klein B., Rapee R., Shann C., Richards D.A., Andersson G., Ritterbrand L., Purtell C., Bezuidenhout G., Johnston L., Nielssen O. MindSpot Clinic: an accessible, efficient and effective online treatment service for anxiety and depression. Psychiatric Services 2015, (in press).
67. Titov N., Dear B.F., Ali S., Zou J.B., Lorian C.N., Johnston L., Terides M.D., Kayrouz R., Klein B., Gandy M., Fogliati V.J. Clinical and cost-effectiveness of therapist-guided internet-delivered cognitive behavior therapy for older adults with symptoms of depression: a randomized controlled trial. Behavior Therapy 2015, 46(2):193-205.
68. Titov N., Dear B.F., Johnston L., Lorian C., Zou J., Wootton B., Spence J., McEvoy P.M., Rapee R.M. Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: randomised controlled trial. PLoS One 2013, 8(7):e62873.
69. Titov N., Dear B.F., Johnston L., McEvoy P., Wootton B., Terides M.D., Gandy M., Fogliati V.J., Kayrouz R., Rapee R. Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: a 12 month follow-up of a randomised controlled trial. PLoS One 2014, 9(2):e89591.
70. Titov N., Dear B.F., McMillan D., Anderson T., Zou J., Sunderland M. Psychometric Comparison of the PHQ-9 and BDI-II for Measuring Response during Treatment of Depression. Cognitive Behaviour Therapy 2011, 40(2):126-136.
71. Titov N., Dear B.F., Schwencke G., Andrews G., Johnston L., Craske M.G., McEvoy P. Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial. Behaviour Research and Therapy 2011, 49(8):441-452.
72. Titov N., Gibson M., Andrews G., McEvoy P. Internet treatment for social phobia reduces comorbidity. Australian & New Zealand Journal of Psychiatry 2009, 43(8):754-759.
73. Tsao J.C., Mystkowski J.L., Zucker B.G., Craske M.G. Effects of cognitive-behavioral therapy for panic disorder on comorbid conditions: replication and extension. Behavior Therapy 2002, 33(4):493-509.
74. Üstün T., Ayuso-Mateos J.L., Chatterji S., Mathers C., Murray C.J. Global burden of depressive disorders in the year 2000. The British Journal of Psychiatry 2004, 184(5):386-392.
75. Waller G. Evidence-based treatment and therapist drift. Behaviour Research and Therapy 2009, 47(2):119-127.
76. Weeks J.W., Spokas M.E., Heimberg R.G. Psychometric evaluation of the mini-social phobia inventory (Mini-SPIN) in a treatment-seeking sample. Depression and anxiety 2007, 24(6):382-391.
77. Wilamowska Z.A., Thompson-Hollands J., Fairholme C.P., Ellard K.K., Farchione T.J., Barlow D.H. Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depression and Anxiety 2010, 27(10):882-890.
78. World Health Organization (1990). Composite International Diagnostic Interview, Version 1.0. Geneva, World Health Organization.