Journal article
Effects of a transdiagnostic unguided Internet intervention ('velibra') for anxiety disorders in primary care: results of a randomized controlled trial.
- Berger T Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland.
- Urech A Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland.
- Krieger T Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland.
- Stolz T Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland.
- Schulz A Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland.
- Vincent A Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland.
- Moser CT Department of Clinical Psychology and Psychotherapy,University of Bern,Bern,Switzerland.
- Moritz S Department of Psychiatry and Psychotherapy,University Medical Centre Hamburg-Eppendorf,Hamburg,Germany.
- Meyer B Department of Psychology,City University,London,UK.
- 2016-09-23
Published in:
- Psychological medicine. - 2017
Anxiety
Internet
cognitive-behaviour therapy
primary care
transdiagnostic treatments
Adult
Anxiety Disorders
Cognitive Behavioral Therapy
Female
Humans
Internet
Male
Middle Aged
Outcome Assessment, Health Care
Primary Health Care
English
BACKGROUND
Internet-based cognitive-behavioural treatment (ICBT) for anxiety disorders has shown some promise, but no study has yet examined unguided ICBT in primary care. This randomized controlled trial (RCT) investigated whether a transdiagnostic, unguided ICBT programme for anxiety disorders is effective in primary care settings, after a face-to-face consultation with a physician (MD). We hypothesized that care as usual (CAU) plus unguided ICBT would be superior to CAU in reducing anxiety and related symptoms among patients with social anxiety disorder (SAD), panic disorder with or without agoraphobia (PDA) and/or generalized anxiety disorder (GAD).
METHOD
Adults (n = 139) with at least one of these anxiety disorders, as reported by their MD and confirmed by a structured diagnostic interview, were randomized. Unguided ICBT was provided by a novel transdiagnostic ICBT programme ('velibra'). Primary outcomes were generic measures, such as anxiety and depression symptom severity, and diagnostic status at post-treatment (9 weeks). Secondary outcomes included anxiety disorder-specific measures, quality of life, treatment adherence, satisfaction, and general psychiatric symptomatology at follow-up (6 months after randomization).
RESULTS
CAU plus unguided ICBT was more effective than CAU at post-treatment, with small to medium between-group effect sizes on primary (Cohen's d = 0.41-0.47) and secondary (Cohen's d = 0.16-0.61) outcomes. Treatment gains were maintained at follow-up. In the treatment group, 28.2% of those with a SAD diagnosis, 38.3% with a PDA diagnosis, and 44.8% with a GAD diagnosis at pretreatment no longer fulfilled diagnostic criteria at post-treatment.
CONCLUSIONS
The unguided ICBT intervention examined is effective for anxiety disorders when delivered in primary care.
Internet-based cognitive-behavioural treatment (ICBT) for anxiety disorders has shown some promise, but no study has yet examined unguided ICBT in primary care. This randomized controlled trial (RCT) investigated whether a transdiagnostic, unguided ICBT programme for anxiety disorders is effective in primary care settings, after a face-to-face consultation with a physician (MD). We hypothesized that care as usual (CAU) plus unguided ICBT would be superior to CAU in reducing anxiety and related symptoms among patients with social anxiety disorder (SAD), panic disorder with or without agoraphobia (PDA) and/or generalized anxiety disorder (GAD).
METHOD
Adults (n = 139) with at least one of these anxiety disorders, as reported by their MD and confirmed by a structured diagnostic interview, were randomized. Unguided ICBT was provided by a novel transdiagnostic ICBT programme ('velibra'). Primary outcomes were generic measures, such as anxiety and depression symptom severity, and diagnostic status at post-treatment (9 weeks). Secondary outcomes included anxiety disorder-specific measures, quality of life, treatment adherence, satisfaction, and general psychiatric symptomatology at follow-up (6 months after randomization).
RESULTS
CAU plus unguided ICBT was more effective than CAU at post-treatment, with small to medium between-group effect sizes on primary (Cohen's d = 0.41-0.47) and secondary (Cohen's d = 0.16-0.61) outcomes. Treatment gains were maintained at follow-up. In the treatment group, 28.2% of those with a SAD diagnosis, 38.3% with a PDA diagnosis, and 44.8% with a GAD diagnosis at pretreatment no longer fulfilled diagnostic criteria at post-treatment.
CONCLUSIONS
The unguided ICBT intervention examined is effective for anxiety disorders when delivered in primary care.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1017/S0033291716002270
- PMID 27655039
- Persistent URL
- https://sonar.ch/global/documents/185015
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