Transdiagnostic cognitive behavioral therapy versus treatment asusual in adult patients with emotional disorders in the primarycaresetting (PsicAP Study): protocol for a Randomized Controlled Trial
BACKGROUND Demand for primary care (PC) services in Spain exceeds available resources. Part of this strong demand is due to the high prevalence of emotional disorders (EDs)-anxiety, depression, and somatic symptom disorders-and related comorbidities such as pain or chronic illnesses. EDs are often under- or misdiagnosed by general practitioners (GPs) and, consequently, treatment is frequently inadequate. OBJECTIVE We aim to compare the short- and long-term effectiveness of group-delivered transdiagnostic cognitive behavioral therapy (TD-CBT) versus treatment as usual (TAU) in the treatment of EDs in the PC setting in Spain. We also aim to compare the effect of these treatments on disability…
Factorial invariance of a computerized version of the GAD-7 across various demographic groups and over time in primary care patients.
Abstract Background The Generalized Anxiety Disorder 7-item scale (GAD-7) is commonly used by clinicians and researchers to screen for anxiety disorders and to monitor anxiety symptoms in primary care. However, findings regarding its factor structure are mixed, with most studies reporting a best-fitting for a one-factor structure, whereas others indicate a two-factor model. To be valid for comparisons, the GAD-7 should measure the same latent construct with the same structure across groups and over time. We aimed to examine the best-fit factor structure model of the GAD-7 among primary care patients and to evaluate its measurement invariance. Methods A total of 1255 patients completed the c…
The mediating role of emotion regulation in transdiagnostic cognitive behavioural therapy for emotional disorders in primary care: Secondary analyses of the PsicAP randomized controlled trial
Background: Emotional disorders are highly prevalent in primary care. Transdiagnostic cognitive behavior therapy (TD-CBT) is a promising treatment of emotional disorders. In this study, we evaluated several emotion regulation strategies as potential mediators of treatment outcomes in a clinical sample of primary care. Methods: A total of 1061 primary care patients were included in a randomized clinical trial comparing treatment- as-usual (TAU) to TD-CBT+TAU. Of these, 631 (TAU=316; TD-CBT+TAU=315) completed the full treatment and all pre- and post-treatment scales to assess symptoms (anxiety, depression, somatization), emotion regulation strategies (worry, rumination, negative metacognition…
La regulación emocional en el ámbito de la atención primaria
Las emociones tienen un papel importante en los procesos adaptativos y desadaptativos, ya que las personas influyen en las emociones que tienen y en cómo las expresan y experimentan, por lo que los trastornos emocionales se relacionan con una regulación emocional disfuncional. Estos trastornos presentan una alta prevalencia entre la población general, y más en concreto en las consultas de atención primaria. Los más prevalentes son la depresión, la ansiedad y las somatizaciones, es decir, aquellos que están relacionados con procesos emocionales. En esta línea, los déficits en regulación emocional parecen ser relevantes para el desarrollo, mantenimiento y tratamiento de distintas formas de ps…
Factor structure and measurement invariance across various demographic groups and over time for the phq-9 in primary care patients in spain
The Patient Health Questionnaire (PHQ-9) is a widely-used screening tool for depression in primary care settings. The purpose of the present study is to identify the factor structure of the PHQ-9 and to examine the measurement invariance of this instrument across different sociodemographic groups and over time in a sample of primary care patients in Spain. Data came from 836 primary care patients enrolled in a randomized controlled trial (PsicAP study) and a subsample of 218 patients who participated in a follow-up assessment at 3 months. Confirmatory factor analysis (CFA) was used to test one- and two-factor structures identified in previous studies. Analyses of multiple-group invariance w…
The PHQ-PD as a screening tool for panic disorder in the primary care setting in Spain
INTRODUCTION Panic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres. METHOD We compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entir…
A way to screen for suffering in palliative care
We report a new tool for screening the suffering of terminally ill patients in a palliative care service. We systematically asked 371 terminal oncological and AIDS patients on 665 different occasions, “How long did yesterday seem to you?”; we then asked them to assess their current condition. The simple answer about subjective length of time correlated well with subjective suffering in approximately half the patients. Thus it may be a good starting point for future assessment and more extensive explorations.