title: Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial.
abstract: Disorder-specific cognitive behavior therapy (DS-CBT) is effective at treating major depressive disorder (MDD) while transdiagnostic CBT (TD-CBT) addresses both principal and comorbid disorders by targeting underlying and common symptoms. The relative benefits of these two models of therapy have not been determined. Participants with MDD (n=290) were randomly allocated to receive an internet delivered TD-CBT or DS-CBT intervention delivered in either clinician-guided (CG-CBT) or self-guided (SG-CBT) formats. Large reductions in symptoms of MDD (Cohen's d≥1.44; avg. reduction≥45%) and moderate-to-large reductions in symptoms of comorbid generalised anxiety disorder (Cohen's d≥1.08; avg. reduction≥43%), social anxiety disorder (Cohen's d≥0.65; avg. reduction≥29%) and panic disorder (Cohen's d≥0.45; avg. reduction≥31%) were found. No marked or consistent differences were observed across the four conditions, highlighting the efficacy of different forms of CBT at treating MDD and comorbid disorders.
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Titov
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: blake.dear@mq.edu.au.
authors.forename: B F
authors.initials: BF
authors.lastname: Dear
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: L G
authors.initials: LG
authors.lastname: Staples
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: M D
authors.initials: MD
authors.lastname: Terides
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Karin
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Sheehan
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Johnston
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Gandy
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
authors.forename: V J
authors.initials: VJ
authors.lastname: Fogliati
authors.affiliation: eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia; School of Medicine (Psychology), University of Tasmania, Tasmania, Australia.
authors.forename: B M
authors.initials: BM
authors.lastname: Wootton
authors.affiliation: School of Psychology and Speech Pathology, Curtin University, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: McEvoy
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000628:therapy; D017060:Patient Satisfaction; D010698:Phobic Disorders / Q000150:complications / Q000628:therapy; D019114:Remote Consultation / Q000379:methods; D012648:Self Care / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: 24-month follow-up; Anxiety disorders; Disorder-specific; Internet; Major depressive disorder; Randomized controlled trial; Self- guided; Therapist-guided; Transdiagnostic; Treatment