Unified protocol för behandling av barn och ungdomar med ångestsyndrom
Fråga och sammanfattning
Ångest är vanligt bland barn och ungdomar och förkommer ofta tillsammans med annan problematik som nedstämdhet och depression. Unified protocol är ett terapeutiskt behandlingsupplägg som är framtaget för att behandla de underliggande faktorer som är gemensamma för flera psykiska sjukdomar. Protokollet är utvecklat för att kunna användas både vid samsjuklighet och vid enskilda diagnoser.
Fråga
Vilken sammanställd forskning och vetenskapliga studier finns om effekter av behandling med Unified protocol av barn och ungdomar med ångestsyndrom?
Frågeställare: Enhetschef, Barn- och ungdomspsykiatrin, Region Stockholm
Sammanfattning
SBU:s upplysningstjänst har efter litteratursökning inte identifierat någon relevant systematisk översikt.
Upplysningstjänsten har dock identifierat tre artiklar från primärstudier. Dessa har undersökt Unified protocol för behandling av barn och ungdomar med olika typer av ångestdiagnoser. Primärstudier granskas inte med avseende på risk för bias av Upplysningstjänsten så inga resultat eller slutsatser har redovisats i svaret, men studierna finns kortfattat beskrivna i tabell.
Bakgrund
Ängslan, oro och ångest är vanligt förekommande symtom i befolkningen, mest uttalat hos barn och ungdomar. Om symtomen är så svåra att de leder till funktionsnedsättningar och inskränkningar i det dagliga livet kan ångestsyndrom föreligga. Olika ångestsyndrom definieras utifrån specifika kriterier och diagnoser ställs av läkare och i vissa fall av psykologer. Ångestsyndrom är vanligt förekommande i alla åldrar och uppskattningsvis utvecklar omkring 25 procent av befolkningen dessa besvär någon gång under livet. Ångestsyndrom är även vanligt hos barn och unga och ibland föreligger samtidig annan psykisk eller fysisk sjukdom [1].
Unified protocol är ett psykoterapeutiskt behandlingsupplägg som syftar till att behandla flera olika psykiatriska tillstånd samtidigt. Behandlingsprotokollet är en form av kognitiv beteendeterapi (KBT) som är utvecklat för att behandla bakomliggande faktorer gemensamma för flera olika psykiatriska symtom och därmed göra behandlingen mer effektiv vid till exempel samsjuklighet med flera olika diagnoser. Ett annat syfte är att göra det lättare för behandlande personal då flera tillstånd kan behandlas på samma sätt [2] [3].
Avgränsningar
Upplysningstjänsten har gjort sökningar (se Bilaga 1) i databaserna Medline, Embase, PsycInfo och Psychology and Behavioral Sciences Collection. Vi har även sökt publikationer på webbsidor för Socialstyrelsen, regionala HTA-organisationer och INAHTA.
Upplysningstjänsten har tillsammans med frågeställaren formulerat frågan enligt följande PICO1:
- Population: Barn och ungdomar upp till 17 år med ångestsyndrom
- Intervention: Unified protocol
- Control: Annan aktiv psykologisk behandling eller ingen behandling
- Outcome: Grad av ångest, remission
För att vi skulle inkludera en artikel i svaret krävde vi att den var publicerad på engelska eller ett av de skandinaviska språken.
Endast artiklar som genomgått en peer review är inkluderade.
För att inkluderas som en systematisk översikt ska författarna ha presenterat en litteratursökning som matchar frågeställningen och är dokumenterad så att det går att bedöma hur väl sökningen täcker området och risken för att den missar relevant litteratur.
1. PICO är en förkortning för patient/population/problem, intervention/index test, comparison/control (jämförelseintervention) och outcome (utfallsmått).
Bedömning av risk för bias
Primärstudier bedöms inte för risk för bias av SBU:s upplysningstjänst eftersom det ställer krav på sakkunskap inom forskningsområdet. Det är därför möjligt att flera av de relevanta primärstudier som inkluderats i svaret kan ha högre risk för bias än de studier som SBU inkluderar i andra rapporter.
Resultat från sökningen
Upplysningstjänstens litteratursökning genererade efter dubblettkontroll totalt 262 artikelsammanfattningar (abstrakt) för översiktsartiklar och 560 abstrakt för primärstudier. Ett flödesschema för urvalsprocessen visas i Bilaga 2. Två utredare på SBU läste alla artikelsammanfattningar för översiktsartiklar och bedömde att åtta kunde vara relevanta för frågan. Dessa artiklar lästes i fulltext av två utredare och de artiklar som inte var relevanta för frågan exkluderades. En utredare på SBU läste alla artikelsammanfattningar för primärstudier och bedömde att 39 artiklar kunde vara relevanta för frågan. Dessa artiklar lästes i fulltext av en utredare och de artiklar som inte var relevanta för frågan exkluderades. Exkluderade artiklar finns listade i Bilaga 3.
Systematiska översikter
Upplysningstjänsten fann ingen systematisk översikt som var relevant för denna fråga och därför redovisas inga resultat eller slutsatser i Upplysningstjänstens svar.
Primärstudier
SBU:s upplysningstjänst identifierade tre artiklar från primärstudier [4] [5] [6], vilka finns översiktligt beskrivna i Tabell 1. En av dessa studerade ungdomar med ångestsyndrom och jämförde Unified Protocol med ett tillägg av mindfulness med enbart Unified Protocol som behandling [6]. En annan jämförde en version av Unified Protocol anpassad för barn (UP-C) med en annan ångestfokuserad aktiv behandling för barn med ångest- eller depressionsdiagnoser [5]. Den tredje studien undersökte en version av Unified Protocol anpassad för ungdomar (UP-A) och jämförde utfall för ångest och depression hos ungdomar med ångestsyndrom som fått denna behandling jämfört med ungdomar på en väntelista, som inte fått behandlingen än [4]. För dessa studier har inte risken för bias bedömts och av det skälet finns inte resultat eller slutsatser beskrivna i text eller tabell.
| UP-A = Unified Protocol for Adolescents; UP-C = Unified Protocol for Children; RCT = Randomised controlled trial | |||
| Publication | Study type | Population | Treatment |
|---|---|---|---|
| Maleki et al 2020 [6] |
Quasi-experimental study | Adolescents (mean age 13 yrs) with emotional disorders (n=31) | Unified protocol + mindfulness |
| Kennedy et al 2019 [5] |
RCT | Children, 7–13 years, principal diagnosis of an anxiety and/or depressive disorder (n=47) | UP-C |
| Ehrenreich-May et al 2017 [4] |
RCT | Adolescents, 12–17 years, primary diagnosis of an anxiety and/or depressive disorder (n=51) | UP-A |
För att besvara Upplysningstjänstens fråga behövs en systematisk översikt som identifierar alla relevanta primärstudier och som sammanväger resultaten.
Projektgrupp
Detta svar är sammanställt av Idha Kurtdsdotter (utredare), Sally Saad (utredare), Sara Fundell (projektadministratör), Laura Lintamo (produktsamordnare), Per Lytsy (intern sakkunnig) samt Irene Edebert (tillförordnad avdelningschef) vid SBU.
Referenser
- Socialstyrelsen. Nationella riktlinjer för vård vid depression och ångestsyndrom. Stockholm: Socialstyrelsen; 2021. Nationella riktlinjer. [accessed Dec 17 2021]. Available from: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/nationella-riktlinjer/2021-4-7339.pdf.
- Carlucci L, Saggino A, Balsamo M. On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2021;87:101999. Available from: https://doi.org/10.1016/j.cpr.2021.101999.
- Wilamowska ZA, Thompson-Hollands J, Fairholme CP, Ellard KK, Farchione TJ, Barlow DH. Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depress Anxiety. 2010;27(10):882-90. Available from: https://doi.org/10.1002/da.20735.
- Ehrenreich-May J, Rosenfield D, Queen AH, Kennedy SM, Remmes CS, Barlow DH. An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. J Anxiety Disord. 2017;46:46-55. Available from: https://doi.org/10.1016/j.janxdis.2016.10.006.
- Kennedy SM, Bilek EL, Ehrenreich-May J. A Randomized Controlled Pilot Trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children. Behav Modif. 2019;43(3):330-60. Available from: https://doi.org/10.1177/0145445517753940.
- Maleki M, Khorramnia S, Foroughi A, Amiri S, Amiri S. Comparing the effectiveness of the unified protocol in combination with an additional mindfulness treatment to the unified protocol alone as treatment for adolescents diagnosed with emotional disorders. Trends Psychiatry Psychother. 2021;43(1):57-64.
Bilaga 1 Litteratursökning
PsycINFO/Psychology and Behavioral Sciences Collection via EBSCO 17 December 2021
| The final search result, usually found at the end of the documentation, forms the list of abstracts. AB = Abstract; AU = Author; DE = Term from the thesaurus; MH = Exact Subject Heading from CINAHL Subject Headings; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; " " = Citation Marks; searches for an exact phrase; N = Near Operator (N) finds the words if they are a maximum of x words apart from one another, regardless of the order in which they appear.; W = Within Operator (W) finds the words if they are within x words of one another, in the order in which you entered them |
||
| Search terms | Items found | |
|---|---|---|
| Population: Children and adolescents with anxiety | ||
| 1. | DE "Anxiety Disorders" OR DE "Generalized Anxiety Disorder" OR DE "Obsessive Compulsive Disorder" OR DE "Panic Attack" OR DE "Panic Disorder" OR DE "PANIC disorders" OR DE "Phobias" OR DE "Separation Anxiety Disorder" OR TI (Anxiet* OR Obsessive Compulsive Disorder* OR "OCD" OR "GAD" OR Panic Attack* OR Panic Disorder* OR Neurotic Disorder* OR Phobi*) OR AB (Anxiet* OR Obsessive Compulsive Disorder* OR "OCD" OR "GAD" OR Panic Attack* OR Panic Disorder* OR Neurotic Disorder* OR Phobi*) OR SU (Anxiet* OR Obsessive Compulsive Disorder* OR "OCD" OR "GAD" OR Panic Attack* OR Panic Disorder* OR Neurotic Disorder* OR Phobi*) | 314,244 |
| 2. | DE "CHILDREN" OR DE "CHILD patients" OR DE "SCHOOL children" OR ZG "adolescence (13-17 yrs)" OR ZG "school age (6-12 yrs)" OR TI (Child* OR kids OR girl OR girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p#ediatric* OR youngster* OR school* OR ((first or second or third or fourth or fifth or sixth or seventh) N2 grader*) OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*) OR AB (Child* OR kids OR girl OR girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p#ediatric* OR youngster* OR school* OR ((first or second or third or fourth or fifth or sixth or seventh) N2 grader*) OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*) OR SU (Child* OR kids OR girl OR girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p#ediatric* OR youngster* OR school* OR ((first or second or third or fourth or fifth or sixth or seventh) N2 grader*) OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*) | 1,848,600 |
| 3. | S1 AND S2 | 105,862 |
| Intervention: Unified protocol | ||
| 4 | DE "Transdiagnostic Treatment" OR TX ("UP-C" OR (emotion* N3 detective*) OR "UP-Y") OR TI Transdiagnostic* OR AB Transdiagnostic* OR SU Transdiagnostic* | 4,546 |
| 5. | TX "unified protocol" | 423 |
| Study types: systematic reviews | ||
| 6. | DE "Meta Analysis" OR ZC "systematic review" OR ZC "meta analysis" OR DE "Systematic Review" OR TX (systematic* N3 review*) OR TX (metaanaly* OR meta-analy* OR meta analy*) | 224,602 |
| Study types: randomised controlled trials and other trials | ||
| 7. | ZC "treatment outcome/clinical trial" OR DE "Clinical Trials" OR DE "Placebo" OR TI (((singl* OR doubl* OR tripl* OR trebl*)) N2 (blind* OR dumm* OR mask*)) OR ((randomi?ed OR controlled) N2 (study OR trial* OR design OR method* OR test* OR assessment OR experiment OR comparison)) OR ((random*) N3 (assign* OR alloca*)) OR (clinical W2 trial*) OR placebo* OR “wait* list*” OR “comparison group*” OR (control* W1 (group* or condition*)) OR (control* W1 (group* or condition*)) OR ((treatment* OR service* OR care) N2 (usual OR standard OR traditional OR ordinary)) OR (randomi?ed N6 n=) OR (compared N2 control*)) OR AB (((singl* OR doubl* OR tripl* OR trebl*)) N2 (blind* OR dumm* OR mask*)) OR ((randomi?ed OR controlled) N2 (study OR trial* OR design OR method* OR test* OR assessment OR experiment OR comparison)) OR ((random*) N3 (assign* OR alloca*)) OR (clinical W2 trial*) OR placebo* OR “wait* list*” OR “comparison group*” OR (control* W1 (group* or condition*)) OR (control* W1 (group* or condition*)) OR ((treatment* OR service* OR care) N2 (usual OR standard OR traditional OR ordinary)) OR (randomi?ed N6 n=) OR (compared N2 control*)) OR SU (((singl* OR doubl* OR tripl* OR trebl*)) N2 (blind* OR dumm* OR mask*)) OR ((randomi?ed OR controlled) N2 (study OR trial* OR design OR method* OR test* OR assessment OR experiment OR comparison)) OR ((random*) N3 (assign* OR alloca*)) OR (clinical W2 trial*) OR placebo* OR “wait* list*” OR “comparison group*” OR (control* W1 (group* or condition*)) OR (control* W1 (group* or condition*)) OR ((treatment* OR service* OR care) N2 (usual OR standard OR traditional OR ordinary)) OR (randomi?ed N6 n=) OR (compared N2 control*)) | 426,078 |
| Combined sets: | ||
| 8. | S3 AND S4 | 639 |
| 9. | S8 OR S5 | 1,015 |
| 10. | S9 AND S6 | 235 |
| 11. | S9 AND S7 | 248 |
| Final result | ||
| 10 [Systematic reviews] | ||
| 11 [controlled trials] | 248 | |
Cochrane Library via Wiley 17 December 2021 (CDSR, Cochrane Protocols & CENTRAL)
| The final search result, usually found at the end of the documentation, forms the list of abstracts. :au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; " " = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; Cochrane Protocols = Protocols of systematic reviews registered in Cochrane Library; CENTRAL = Cochrane Central Register of Controlled Trials, “trials” |
||
| Search terms | Items found | |
|---|---|---|
| Population: children and adolescents with anxiety | ||
| 1. | MeSH descriptor: [Anxiety Disorders] explode all trees | 7,472 |
| 2. | (Anxiety OR Anxieties OR "Obsessive Compulsive Disorder*" OR OCD OR GAD OR "Panic Attack" OR "Panic Disorder*" OR "Neurotic Disorder*" OR "Phobia*" OR phobic):ti,ab,kw | 61,965 |
| 3. | MeSH descriptor: [Child] explode all trees | 59,662 |
| 4. | MeSH descriptor: [Adolescent] explode all trees | 108,631 |
| 5. | (child* OR kids OR girl OR girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p?ediatric* OR youngster* OR school* OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*):ti,ab,kw | 314,192 |
| 6. | ((first or second or third or fourth or fifth or sixth or seventh) W grader*):ti,ab,kw | 2 |
| 7. | #3 OR #4 OR #5 OR #6 | 314193 |
| 8. | #1 OR #2 | 62,206 |
| 9. | #7 AND #8 | 16,467 |
| Intervention: Unified protocol | ||
| 10. | ("Unified protocol") | 167 |
| 11. | ("UP-C" OR "UP-Y" OR "emotion* detective*" OR transdiagnostic*):ti,ab,kw | 912 |
| Combined sets | ||
| 12. | #9 AND #11 | 203 |
| 13. | #12 OR #10 | 338 |
| Final result | ||
| #13 | CDSR/1 Cochrane Protocols/1 CENTRAL/336 |
|
Embase via Elsevier 17 December 2021
| The final search result, usually found at the end of the documentation, forms the list of abstracts. /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ' ' = Citation Marks; searches for an exact phrase; NEAR/n = Requests terms that are within 'n' words of each other in either direction; NEXT/n = Requests terms that are within 'n' words of each other in the order specified |
||
| Search terms | Items found | |
|---|---|---|
| Population: Children and adolescents with anxiety | ||
| 1. | 'anxiety disorder'/exp OR "Anxiety":ti,ab,kw OR "Anxieties":ti,ab,kw OR "Obsessive Compulsive Disorder":ti,ab,kw OR "Obsessive Compulsive Disorders":ti,ab,kw OR "OCD":ti,ab,kw OR "GAD":ti,ab,kw OR "Panic Attack":ti,ab,kw OR "Panic Disorder":ti,ab,kw OR "Neurotic Disorders":ti,ab,kw OR "Panic Disorders":ti,ab,kw OR "Neurotic Disorder":ti,ab,kw OR "Phobia":ti,ab,kw OR "phobias":ti,ab,kw OR "phobic":ti,ab,kw | 516,165 |
| 2. | 'child'/exp OR 'adolescent'/exp OR child*:ti,ab,kw OR 'kids':ti,ab,kw OR girl:ti,ab,kw OR girls:ti,ab,kw OR boy:ti,ab,kw OR boys:ti,ab,kw OR teen*:ti,ab,kw OR adolescen*:ti,ab,kw OR youth*:ti,ab,kw OR pediatric*:ti,ab,kw OR paediatric*:ti,ab,kw OR youngster*:ti,ab,kw OR school*:ti,ab,kw OR 'first grader*':ti,ab,kw OR 'second grader*':ti,ab,kw OR 'third grader*':ti,ab,kw OR 'fourth grader*':ti,ab,kw OR 'fifth grader*':ti,ab,kw OR 'sixth grader*':ti,ab,kw OR 'seventh grader*':ti,ab,kw OR highschool*:ti,ab,kw OR ((secondary:ti,ab,kw OR high*:ti,ab,kw) AND adj2:ti,ab,kw AND (school*:ti,ab,kw OR education:ti,ab,kw)) OR juvenile*:ti,ab,kw OR minor*:ti,ab,kw | 5,225,380 |
| 3. | 1 AND 2 | 131,769 |
| Intervention: Unified protocol | ||
| 4. | 'up-c':ti,ab,kw OR 'emotion* detective*':ti,ab,kw OR 'up-y':ti,ab,kw OR 'transdiagnostic':ti,ab,kw OR 'transdiagnostical':ti,ab,kw OR 'transdiagnostic approach'/exp | |
| 5. | 'unified protocol'/exp OR 'unified protocol' | |
| Study types: randomised controlled trials and other controlled trials | ||
| 6. | 'controlled clinical trial'/exp | 863,978 |
| 7. | ((‘singl*’ OR ‘doubl*’ OR ‘tripl*’ OR ‘trebl*’) NEXT/3 (‘blind*’ OR ‘dumm*’ OR ‘mask*’)):ti,ab,kw | 262,218 |
| 8. | ('controlled' NEXT/2 (trial OR comparison OR experiment OR study OR test)):ti,ab,kw | 320,958 |
| 9. | (clinical NEAR/3 trial):ti,ab,kw | 267,056 |
| 10. | ('control*' NEXT/1 (group* OR condition*)):ti,ab,kw | 773,552 |
| 11. | 'comparison group*':ti,ab,kw | 25,991 |
| 12. | 'wait* list*':ti,ab,kw | 24,190 |
| 13. | ((treatment OR intervention OR experimental) NEXT/1 group*):ti,ab,kw | 286,289 |
| 14. | (matched NEXT/1 (control* OR group* OR comparison*)):ti,ab,kw | 130,959 |
| 15. | ((treatment* OR service* OR care) NEAR/2 (usual OR standard OR traditional OR ordinary)):ti,ab,kw | 217,862 |
| 16. | (compared NEAR/3 control*):ti,ab,kw | 607,279 |
| 17. | #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 | 2,609,887 |
| Study types: systematic reviews | ||
| 18. | 'systematic review'/de OR 'meta analysis'/exp OR 'cochrane database syst rev':ta OR ((systematic NEAR/3 review):ti,ab) OR 'meta analys*':ti,ab OR metaanalys*:ti,ab | 548,508 |
| Combined sets | ||
| 19. | #3 AND #4 | 629 |
| 20. | #19 OR #5 | 995 |
| 21. | #20 AND #18 [systematic reviews] | 62 |
| 22. | #20 AND #17 [controlled trials] | 201 |
| Final result | ||
| #21[systematic reviews] | 62 | |
| #22 [controlled trials] | 201 | |
Medline via OvidSP 17 December 2021
| The final search result, usually found at the end of the documentation, forms the list of abstracts. .ab. = Abstract; .ab,ti. = Abstract or title; .af. = All fields; Exp = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; .sh. = Term from the Medline controlled vocabulary; .ti. = Title; / = Term from the Medline controlled vocabulary, but does not include terms found below this term in the MeSH hierarchy; * = Focus (if found in front of a MeSH-term); * or $ = Truncation (if found at the end of a free text term); .mp = Text, heading word, subject area node, title; " " = Citation Marks; searches for an exact phrase; ADJn = Positional operator that lets you retrieve records that contain your terms (in any order) within a specified number (n) of words of each other |
||
| Search terms | Items found | |
|---|---|---|
| Population: Children and adolescents with anxiety | ||
| 1. | exp Child/ or exp adolescent/ | 3,199,838 |
| 2. | (child* or kids or girl or girls or boy or boys or teen* or adolescen* or youth* or p?ediatric* or youngster* or school* or highschool* or secondary school* or secondary education* or high school* or juvenile* or minor*).tw,kw. | 2,503,177 |
| 3. | ((first or second or third or fourth or fifth or sixth or seventh) adj grader*).tw,kw | 2,744 |
| 4. | exp Anxiety Disorders/ | 84,490 |
| 5. | (Obsessive Compulsive Disorder* or OCD or GAD or Panic Attack or Panic Disorder* or Neurotic Disorder* or phobi*).kw,tw. | 46,354 |
| 6. | 1 or 2 or 3 [population age] | 4,245,693 |
| 7. | 4 or 5 [population diagnosis] | 104,919 |
| 8. | 6 and 7 [population] | 33,045 |
| Intervention: Unified protocol | ||
| 9. | (Unified protocol or UP-C or UP-Y or emotion* detective*).mp. | 450 |
| 10. | transdiagnostic*.tw,kw. | 3,002 |
| 11. | 9 or 10 | 3,328 |
| Study types: randomised controlled trials and other controlled trials | ||
| 12. | exp Controlled Clinical Trial/ or random allocation/ | 727,611 |
| 13. | ((singl* or doubl* or tripl* or trebl*) adj3 (blind* or dumm* or mask*)).tw,kw. | 186,415 |
| 14. | (clinical adj3 trial).tw,kw. | 169,406 |
| 15. | clinical trial.pt. | 532,426 |
| 16. | random*.tw,kw. | 1,272,900 |
| 17. | (control* adj (group* or condition*)).tw,kw. | 542,714 |
| 18. | comparison group*.tw,kw. | 20,151 |
| 19. | wait* list*.tw,kw. | 14,953 |
| 20. | ((treatment or intervention or experimental) adj group*).tw,kw. | 200,587 |
| 21. | (matched adj (control* or group* or comparison*)).tw,kw. | 95,073 |
| 22. | ((treatment* or service* or care) adj2 (usual or standard or traditional or ordinary)).tw,kw. | 131,615 |
| 23. | (compared adj3 control*).tw,kw. | 412,036 |
| 24. | 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 | 2,670,881 |
| Study types: Systematic reviews | ||
| 25. | (Systematic Review or Meta-Analysis).pt. or Cochrane Database Syst Rev.ja. or ((systematic adj3 review) or "meta analys*" or metaanalys*).ti,ab | 372,242 |
| Combined sets | ||
| 26. | 8 and 11 [population and intervention] | 274 |
| 27. | 26 and 24 [controlled trials] | 85 |
| 28. | 26 and 25 [systematic reviews] | 26 |
| Final result | ||
| 27 [controlled trials] | 85 | |
| 28 [systematic reviews] | 26 | |
Bilaga 2 Flödesschema över urval av studier
Bilaga 3 Artiklar som exkluderats efter fulltextläsning
| Exkluderade artiklar | Orsak till exklusion |
|---|---|
| Systematiska översikter | |
| Carlucci L, Saggino A, Balsamo M. On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2021;87:101999. Available from: https://doi.org/10.1016/j.cpr.2021.101999. | Ingen särredovisning av barn och ungdomar |
| Ebert DD, Zarski AC, Christensen H, Stikkelbroek Y, Cuijpers P, Berking M, et al. Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials. PLoS One. 2015;10(3):e0119895. Available from: https://doi.org/10.1371/journal.pone.0119895. | Fel intervention |
| Ewing DL, Monsen JJ, Thompson EJ, Cartwright-Hatton S, Field A. A Meta-Analysis of Transdiagnostic Cognitive Behavioural Therapy in the Treatment of Child and Young Person Anxiety Disorders. Behav Cogn Psychother. 2015;43(5):562-77. Available from: https://doi.org/10.1017/S1352465813001094. | Fel intervention |
| García-Escalera J, Chorot P, Valiente RM, Reales JM, Sandín B. Efficacy of transdiagnostic cognitive-behavioral therapy for anxiety and depression in adults, children and adolescents: A meta-analysis. Revista de Psicopatología y Psicología Clínica. 2016;21(3):147-75. | Flera typer av transdiagnostiska protokoll analyseras tillsammans. Ingen särredovisning av Unified protocol. |
| Pasarelu CR, Andersson G, Bergman Nordgren L, Dobrean A. Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials. Cogn Behav Ther. 2017;46(1):1-28. Available from: https://doi.org/10.1080/16506073.2016.123121. | Fel population |
| Reinholt N, Krogh J. Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: a systematic review and meta-analysis of published outcome studies. Cogn Behav Ther. 2014;43(3):171-84. Available from: https://doi.org/10.1080/16506073.2014.897367. | Fel population |
| Sakiris NBD. A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review. 2019;72(101751). | Fel population |
| Schafer JO, Naumann E, Holmes EA, Tuschen-Caffier B, Samson AC. Emotion Regulation Strategies in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review. J Youth Adolesc. 2017;46(2):261-76. Available from: https://doi.org/10.1007/s10964-016-0585-0. | Fel intervention |
| Primärstudier | |
| Ahmadi R, Ahmadizadeh R, Hasani M, Saed O. Transdiagnostic versus construct-specific cognitive behavioural therapy for emotional disorders in patients with high anxiety sensitivity: A double-blind randomised clinical trial. Behav Change. 2021. | Fel population |
| Arendt K, Thastum M, Hougaard E. Efficacy of a Danish version of the Cool Kids program: a randomized wait-list controlled trial. Acta Psychiatr Scand. 2016;133(2):109-21. Available from: https://doi.org/10.1111/acps.12448. | Fel intervention |
| Chu BC, Crocco ST, Esseling P, Areizaga MJ, Lindner AM, Skriner LC. Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: Initial randomized controlled trial. Behav Res Ther. 2016;76:65-75. Available from: https://doi.org/10.1016/j.brat.2015.11.005. | Fel intervention |
| Corpas J, Moriana JA, Vencesla JF, Galvez-Lara M. Effectiveness of brief group transdiagnostic therapy for emotional disorders in primary care: A randomized controlled trial identifying predictors of outcome. Psychother Res. 2021:1-14. Available from: https://doi.org/10.1080/10503307.2021.1952331. | Fel population |
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| de Ornelas Maia AC, Nardi AE, Cardoso A. The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial. J Affect Disord. 2015;172:179-83. Available from: https://doi.org/10.1016/j.jad.2014.09.023. | Fel population |
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| Fernández-Martínez I, Morales A, ra, Espada JP, Essau CA, et al. Effectiveness of the program Super Skills For Life in reducing symptoms of anxiety and depression in young Spanish children. Psicothema. 2019;31(3):298-304. | Fel intervention |
| Gallagher MW, Long LJ, Richardson A, D'Souza J, Boswell JF, Farchione TJ, et al. Examining Hope as a Transdiagnostic Mechanism of Change Across Anxiety Disorders and CBT Treatment Protocols. Behav Ther. 2020;51(1):190-202. | Fel population |
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| Gonzalez-Robles A, Diaz-Garcia A, Garcia-Palacios A, Roca P, Ramos-Quiroga JA, Botella C. Effectiveness of a Transdiagnostic Guided Internet-Delivered Protocol for Emotional Disorders Versus Treatment as Usual in Specialized Care: Randomized Controlled Trial J Med Internet Res. 2020;22(7):e18220. | Fel population |
| Gonzalez-Robles A, Garcia-Palacios A, Banos R, Quero S, Botella C. Upregulating Positive Affectivity in the Transdiagnostic Treatment of Emotional Disorders: A Randomized Pilot Study. Behav Modif. 2019;43(1):26-55. Available from: https://doi.org/10.1177/0145445517735631. | Fel population |
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| Johnston L, Titov N, Andrews G, Dear BF, Spence J. Comorbidity and internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders. Cogn Behav Ther. 2013;42(3):180-92. Available from: https://doi.org/10.1080/16506073.2012.753108. | Fel population |
| Johnstone KM, Middleton T, Kemps E, Chen J. A pilot investigation of universal school-based prevention programs for anxiety and depression symptomology in children: A randomized controlled trial. J Clin Psychol. 2020;76(7):1193-216. Available from: https://doi.org/10.1002/jclp.22926. | Fel intervention |
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| Khakpoor S, Bytamar JM, Saed O. Reductions in transdiagnostic factors as the potential mechanisms of change in treatment outcomes in the Unified Protocol: A randomized clinical trial. Res Psychother. 2019;22(3):402-12. | Fel population |
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| Mahmoodi M, Bakhtiyari M, Masjedi Arani A, Mohammadi A, Saberi Isfeedvajani M. The comparison between CBT focused on perfectionism and CBT focused on emotion regulation for individuals with depression and anxiety disorders and dysfunctional perfectionism: a randomized controlled trial. Behav Cogn Psychother. 49(4):454-71. | Fel population |
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| Shaw AM, Halliday ER, Ehrenreich-May J. The effect of transdiagnostic emotion-focused treatment on obsessive-compulsive symptoms in children and adolescents. J Obsessive Compuls Relat Disord. 2020;26. | Fel studiedesign – kontrollgrupp saknas |
| Tirpak JW, Cassiello-Robbins C, Ametaj A, Olesnycky OS, Sauer-Zavala S, Farchione TJ, et al. Changes in positive affect in cognitive-behavioral treatment of anxiety disorders. Gen Hosp Psychiatry. 2019;61:111-5. | Fel population |
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| Woods BK, Sauer-Zavala S, Farchione TJ, Barlow DH. Isolating the Effects of Mindfulness Training Across Anxiety Disorder Diagnoses in the Unified Protocol. Behav Ther. 2020;51(6):972-83. Available from: https://doi.org/10.1016/j.beth.2020.01.001. | Fel population |
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