Transdiagnostic CBT for anxiety and depression dismantling meta analysis

Transdiagnostic CBT protocols were examined in a meta-analysis, data coded based on treatment mode, duration, and components of TD-CBT protocols involving adults who received a published TD-CBT intervention (or details were included in the article of protocol components) in an RCT where a control group received either disorder specific CBT (DS-CBT), treatment as usual (TAU), or were in a waitlist control condition. Moderate effect sizes favouring TD-CBT for anxiety and depression were found. No significant effect for treatment mode was identified. Statistically significant differences were found by treatment duration for anxiety outcomes; short treatment (less than eight weeks) showed large effect sizes, whereas longer treatment (10 weeks or longer) showed small effect sizes. Statistically significant differences for both anxiety and depression were found favouring TD-CBT interventions with fewer components. Results suggest efficacy in individual, group, or internet delivered modes. The results suggest that treatment effect may not be enhanced by longer intervention. Focusing on fewer treatment components may confer advantages through greater mastery by clinician and client.本研究针对跨诊断认知行为疗法（Transdiagnostic CBT, TD-CBT）方案开展了一项元分析。研究数据依据治疗模式、疗程时长以及TD-CBT方案的核心构成要素进行编码，纳入的研究均为随机对照试验（Randomized Controlled Trial, RCT），受试者为接受已发表TD-CBT干预的成人群体（或文章中披露了方案构成要素的详细信息），且对照组分别接受特定障碍认知行为疗法（Disorder Specific CBT, DS-CBT）、常规治疗（Treatment as Usual, TAU）或设置为等待名单对照组。结果显示，针对焦虑与抑郁症状，TD-CBT的干预效应量处于中等水平且疗效优于对照组；未发现治疗模式对干预效果存在显著影响。针对焦虑症状的疗效分析显示，治疗时长存在统计学意义上的显著差异：疗程短于8周的短程干预呈现出大效应量，而疗程达10周及以上的长程干预仅呈现出小效应量。针对焦虑与抑郁症状的分析均发现，组分更少的TD-CBT干预方案疗效更优，且差异具有统计学意义。研究结果表明，TD-CBT在个体治疗、团体治疗以及互联网递送模式下均展现出临床有效性。此外，更长的干预时长似乎并未提升治疗效果；而减少治疗组分，则可能通过提升临床医师与来访者对方案的掌握程度，为干预带来额外优势。