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BMC Psychiatry
Published in: BMC Psychiatry 1/2024

Open Access 01-12-2024 | Mood Disorders | Research

Concentrated transdiagnostic and cross-disciplinary micro-choice based group treatment for patients with depression and with anxiety leads to lasting improvements after 12 months: a pilot study

Authors: Ane Wilhelmsen-Langeland, Tore Børtveit, Marte Jürgensen, Eirik Søfteland, Sigurd William Hystad, Gerd Kvale

Published in: BMC Psychiatry | Issue 1/2024

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Abstract

Background

A concentrated transdiagnostic and micro choice-based group treatment for patients with depression and anxiety has previously shown to yield significant reduction in symptoms and increased level of functioning from pre to 3-month follow-up. In the present study, we report the results after 12 months follow-up.

Methods

This was a non-randomized clinical intervention pilot study, conducted in line with a published protocol. Sixty-seven consecutively referred patients, aged 19–47 (mean age 32.5, SD = 8.0) were included and completed treatment. All had a severity of their problems that entitled them to care in the specialist public mental health care. Self-reported age at onset of symptoms was 17.6 (SD = 7.9) years. Mean number of prior treatment courses was 3.5 (SD = 3.3; range 0–20). The main objective was to assess the treatment effectiveness by questionnaires measuring relevant symptoms at pre-treatment, 7 days-, 3 months-, 6 months- and at 12-months follow-up.

Results

Validated measures of functional impairment (WSAS), depression (PHQ9), anxiety (GAD7), worry (PSWQ), fatigue (CFQ), insomnia (BIS) and illness perception (BIPQ) improved significantly (p < .0005) from before treatment to 12 months follow-up, yielding mostly large to extremely large effect sizes (0.89–3.68), whereas some moderate (0.60–0.76). After 12 months, 74% report an overall improvement in problems related to anxiety and depression. Utilization of specialist, public and private mental health care was reported as nonexistent or had decreased for 70% of the patients at 12-month follow up.

Conclusions

The concentrated, micro-choice based group treatment approach yielded a highly clinically significant reduction in a wide range of symptoms already one week after treatment, and the positive results persisted at 12-month follow-up.

Trial registration

ClinicalTrials.gov Identifier: NCT05234281, first posted date 10/02/2022.
Literature
1.
Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialog Clin Neurosci. 2015;17(3):327–35.CrossRef
2.
Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of Depression in the community from 30 countries between 1994 and 2014. Sci Rep. 2018;8(1):2861.PubMedPubMedCentralCrossRef
3.
Öst LG, Enebrink P, Finnes A, Ghaderi A, Havnen A, Kvale G, et al. Cognitive behavior therapy for obsessive-compulsive disorder in routine clinical care: a systematic review and meta-analysis. Behav Res Ther. 2022;159:104170.PubMedCrossRef
4.
Öst LG, Enebrink P, Finnes A, Ghaderi A, Havnen A, Kvale G, et al. Cognitive behavior therapy for adult depressive disorders in routine clinical care: a systematic review and meta-analysis. J Affect Disord. 2023;331:322–33.PubMedCrossRef
5.
Öst LG, Enebrink P, Finnes A, Ghaderi A, Havnen A, Kvale G, et al. Cognitive behavior therapy for adult post-traumatic stress disorder in routine clinical care: a systematic review and meta-analysis. Behav Res Ther. 2023;166:104323.PubMedCrossRef
6.
Kvale G, Wilhelmsen-Langeland A, Jürgensen M, Hystad SW, Öst LG, Søfteland E, Børtveit T. Concentrated transdiagnostic and cross-disciplinary group treatment for patients with depression and with anxiety: a pilot study. BMC Psychiatry. 2022;22(1):587.PubMedPubMedCentralCrossRef
7.
Frisk B, Jürgensen M, Espehaug B, Njøten KL, Søfteland E, Aarli BB, Kvale G. A safe and effective micro-choice based rehabilitation for patients with long COVID: results from a quasi-experimental study. Sci Rep. 2023;13(1):9423.PubMedPubMedCentralCrossRef
8.
Hansen B, Hagen K, Öst LG, Solem S, Kvale G. The Bergen 4-Day OCD treatment delivered in a Group setting: 12-Month Follow-Up. Front Psychol. 2018;9:639.PubMedPubMedCentralCrossRef
9.
Haukebø K, Skaret E, Ost LG, Raadal M, Berg E, Sundberg H, Kvale G. One- vs. five-session treatment of dental phobia: a randomized controlled study. J Behav Ther Exp Psychiatry. 2008;39(3):381–90.PubMedCrossRef
10.
Kvale G, Hansen B, Björgvinsson T, Børtveit T, Hagen K, Haseth S, et al. Successfully treating 90 patients with obsessive compulsive disorder in eight days: the Bergen 4-day treatment. BMC Psychiatry. 2018;18(1):323.PubMedPubMedCentralCrossRef
11.
Stubhaug B, Lier HO, Aßmus J, Rongve A, Kvale G. A 4-Day mindfulness-based cognitive behavioral intervention program for CFS/ME. An Open Study, with 1-Year Follow-Up. Front Psychiatry. 2018;9:720.PubMedPubMedCentralCrossRef
12.
Hagen K, Nordahl H, Launes G, Kvale G, Öst LG, Hystad S, et al. Does concentrated exposure treatment for obsessive-compulsive disorder improve insomnia symptoms? Results from a Randomized Controlled Trial. Front Psychiatry. 2021;12:625631.PubMedPubMedCentralCrossRef
13.
Frisk B, Njøten KL, Aarli B, Hystad SW, Rykken S, Kjosås A, et al. A Novel Concentrated, Interdisciplinary Group Rehabilitation Program for patients with Chronic Obstructive Pulmonary Disease: protocol for a nonrandomized clinical intervention study. JMIR Res Protocols. 2022;11(10):e40700.CrossRef
14.
Kvale G, Frisk B, Jürgensen M, Børtveit T, Ødegaard-Olsen ØT, Wilhelmsen-Langeland A, et al. Evaluation of Novel Concentrated Interdisciplinary Group Rehabilitation for patients with chronic illnesses: protocol for a nonrandomized clinical intervention study. JMIR Res Protocols. 2021;10(10):e32216.CrossRef
15.
Kvale G, Søfteland E, Jürgensen M, Wilhelmsen-Langeland A, Haugstvedt A, Hystad SW, et al. First trans-diagnostic experiences with a novel micro-choice based concentrated group rehabilitation for patients with low back pain, long COVID, and type 2 diabetes: a pilot study. BMC Med. 2024;22(1):12.PubMedPubMedCentralCrossRef
16.
Norwegian Directorate of Health. Mental healthcare for adults. Priority guideline. 2015.
17.
World Health Organization. In: Organization WH, editor. The ICD-10 classification of mental and behavioural disorders. Genevè: World Health Organization; 1992.
18.
Möller HJ, Bandelow B, Volz HP, Barnikol UB, Seifritz E, Kasper S. The relevance of ‘mixed anxiety and depression’ as a diagnostic category in clinical practice. Eur Arch Psychiatry Clin Neurosci. 2016;266(8):725–36.PubMedPubMedCentralCrossRef
19.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The mini-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33. quiz 4–57.PubMed
20.
Mordal J, Gundersen O, Bramness JG. Norwegian version of the mini-international neuropsychiatric interview: feasibility, acceptability and test-retest reliability in an acute psychiatric ward. Eur Psychiatry: J Association Eur Psychiatrists. 2010;25(3):172–7.CrossRef
21.
Sheehan DV, Janavs J, Baker R, Harnett-Shehaan K, Knapp E, Sheehan M. M.I.N.I. Plus: Mini international neuropsychiatric interview. 2002.
22.
Mundt JC, Marks IM, Shear MK, Greist JH. The work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry: J Mental Sci. 2002;180:461–4.CrossRef
23.
24.
Levis B, Sun Y, He C, Wu Y, Krishnan A, Bhandari PM, et al. Accuracy of the PHQ-2 alone and in Combination with the PHQ-9 for screening to detect Major Depression: systematic review and Meta-analysis. JAMA. 2020;323(22):2290–300.PubMedPubMedCentralCrossRef
25.
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.PubMedCrossRef
26.
Meyer TJ, Miller ML, Metzger RL, Borkovec TD. Development and validation of the Penn State worry questionnaire. Behav Res Ther. 1990;28(6):487–95.PubMedCrossRef
27.
Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, Wright D, Wallace EP. Development of a fatigue scale. J Psychosom Res. 1993;37(2):147–53.PubMedCrossRef
28.
Loge JH, Ekeberg O, Kaasa S. Fatigue in the general Norwegian population: normative data and associations. J Psychosom Res. 1998;45(1):53–65.PubMedCrossRef
29.
Pallesen S, Bjorvatn B, Nordhus IH, Sivertsen B, Hjornevik M, Morin CM. A new scale for measuring insomnia: the Bergen Insomnia Scale. Percept Motor Skills. 2008;107(3):691–706.PubMedCrossRef
30.
American Psychiatric Association. In: Association AP, editor. Diagnostic and statistical manual of mental disorders: DSM-IV. 4th ed. Washingtin, DC: APA; 1994.
31.
Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60(6):631–7.PubMedCrossRef
32.
Broadbent E, Wilkes C, Koschwanez H, Weinman J, Norton S, Petrie KJ. A systematic review and meta-analysis of the brief illness perception Questionnaire. Psychol Health. 2015;30(11):1361–85.PubMedCrossRef
33.
Chang D, Hwang S. The development of anger management program based on acceptance and commitment therapy for youth taekwondo players. J Exerc Rehabil. 2017;13(2):160–7.PubMedPubMedCentralCrossRef
34.
Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863.PubMedPubMedCentralCrossRef
35.
StataCorp. Stata Statistical Software. TX: College Station; 2021.
36.
Levis B, Benedetti A, Thombs BD. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:l1476.PubMedPubMedCentralCrossRef
37.
Hagen K, Solem S, Stavrum AK, Eid J, Kvale G, Samdal O, Hellard SL. Mental health symptoms during the first months of the COVID-19 outbreak in Norway: a cross-sectional survey study. Scand J Public Health. 2022;50(6):730–7.PubMedCrossRef
38.
Hagen K, Solem S, Stavrum AK, Eid J, Kvale G, Samdal O, Le Hellard S. Changes in mental health symptoms from April (COVID-19 outbreak) to December 2020 in Norway: a two-wave study. Cogent Psychol. 2023;10(1):2173998.CrossRef
39.
Moreno-Agostino D, Fisher HL, Goodman A, Hatch SL, Morgan C, Richards M, et al. Long-term psychological distress trajectories and the COVID-19 pandemic in three British birth cohorts: a multi-cohort study. PLoS Med. 2023;20(4):e1004145.PubMedPubMedCentralCrossRef
40.
Patel K, Robertson E, Kwong ASF, Griffith GJ, Willan K, Green MJ, et al. Psychological distress before and during the COVID-19 pandemic among adults in the United Kingdom Based on coordinated analyses of 11 longitudinal studies. JAMA Netw Open. 2022;5(4):e227629.PubMedPubMedCentralCrossRef
41.
Unnarsdóttir AB, Lovik A, Fawns-Ritchie C, Ask H, Kõiv K, Hagen K, et al. Cohort Profile: COVIDMENT: COVID-19 cohorts on mental health across six nations. Int J Epidemiol. 2022;51(3):e108–22.PubMedCrossRef
42.
Knapstad M, Nordgreen T, Smith ORF. Prompt mental health care, the Norwegian version of IAPT: clinical outcomes and predictors of change in a multicenter cohort study. BMC Psychiatry. 2018;18(1):260.PubMedPubMedCentralCrossRef
43.
Halsøy Ø, Johnson SU, Hoffart A, Ebrahimi OV. Insomnia symptoms in the General Population during the COVID-19 pandemic. Front Psychiatry. 2021;12:762799.PubMedPubMedCentralCrossRef
44.
Hallgren M, Helgadóttir B, Herring MP, Zeebari Z, Lindefors N, Kaldo V, et al. Exercise and internet-based cognitive-behavioural therapy for depression: multicentre randomised controlled trial with 12-month follow-up. Br J Psychiatry: J Mental Sci. 2016;209(5):414–20.CrossRef
45.
JGL AT, Morina N, Topper M, Emmelkamp PMG. One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression. BMC Psychiatry. 2021;21(1):41.CrossRef
46.
Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, et al. The Unified Protocol for Transdiagnostic Treatment of Emotional disorders compared with diagnosis-specific protocols for anxiety disorders: a Randomized Clinical Trial. JAMA Psychiatry. 2017;74(9):875–84.PubMedPubMedCentralCrossRef
47.
Eustis EH, Gallagher MW, Tirpak JW, Nauphal M, Farchione TJ, Barlow DH. The unified protocol compared with diagnosis-specific protocols for anxiety disorders: 12-month follow-up from a randomized clinical trial. Gen Hosp Psychiatry. 2020;67:58–61.PubMedPubMedCentralCrossRef
48.
Blom K, Jernelöv S, Kraepelien M, Bergdahl MO, Jungmarker K, Ankartjärn L, et al. Internet treatment addressing either Insomnia or Depression, for patients with both diagnoses: a Randomized Trial. Sleep. 2015;38(2):267–77.PubMedPubMedCentralCrossRef
49.
Meaklim H, Saunders WJ, Byrne ML, Junge MF, Varma P, Finck WA, Jackson ML. Insomnia is a key risk factor for persistent anxiety and depressive symptoms: a 12-month longitudinal cohort study during the COVID-19 pandemic. J Affect Disord. 2023;322:52–62.PubMedCrossRef
50.
Sivertsen B, Øverland S, Bjorvatn B, Mæland JG, Mykletun A. Does Insomnia predict sick leave? The Hordaland Health Study. J Psychosom Res. 2009;66(1):67–74.PubMedCrossRef
51.
Ansar N, Nissen Lie HA, Stiegler JR. The effects of emotion-focused skills training on parental mental health, emotion regulation and self-efficacy: mediating processes between parents and children. Psychother Res. 2023:1–20.
52.
Phua DY, Kee MZL, Meaney MJ. Positive Maternal Mental Health, parenting, and Child Development. Biol Psychiatry. 2020;87(4):328–37.PubMedCrossRef
Metadata
Title
Concentrated transdiagnostic and cross-disciplinary micro-choice based group treatment for patients with depression and with anxiety leads to lasting improvements after 12 months: a pilot study
Authors
Ane Wilhelmsen-Langeland
Tore Børtveit
Marte Jürgensen
Eirik Søfteland
Sigurd William Hystad
Gerd Kvale
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2024
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-024-05786-0

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