Differential Effect of Transdiagnostic Cognitive-Behaviour Therapy on Health-Related Quality of Life According to the Number of Anxiety Comorbidities
Author(s)
Alexandra Chapdelaine, PhD1, Helen-Maria Vasiliadis, PhD2, Martin D Provencher, PhD3, Peter J Norton, PhD4, Pasquale Roberge, PhD5.
1Family Medecine and Emergency Medicine Department, Université de Sherbrooke, Sherbrooke, QC, Canada, 2Community Health Sciences Departement, Université de Sherbrooke - Campus Longueuil, Longueuil, QC, Canada, 3École de psychologie, Université Laval, Québec, QC, Canada, 4Cairnmillar Institute, Melbourne, Australia, 5Family Medecine and Emergency Medecine Department, Université de Sherbrooke, Sherbrooke, QC, Canada.
1Family Medecine and Emergency Medicine Department, Université de Sherbrooke, Sherbrooke, QC, Canada, 2Community Health Sciences Departement, Université de Sherbrooke - Campus Longueuil, Longueuil, QC, Canada, 3École de psychologie, Université Laval, Québec, QC, Canada, 4Cairnmillar Institute, Melbourne, Australia, 5Family Medecine and Emergency Medecine Department, Université de Sherbrooke, Sherbrooke, QC, Canada.
Presentation Documents
OBJECTIVES: Anxiety disorders (AD) are among the most prevalent mental health disorders. Cognitive behavioural therapy (CBT) is the most empirically supported psychotherapy approach for anxiety disorders, but access remains an issue in many countries. Transdiagnostic CBT (tCBT) uses a single protocol which facilitates treatment delivery for individuals with comorbid anxiety disorders with a mixed group format. As comorbidities may be associated with more severe clinical profiles, we aim to evaluate the effect of tCBT on health-related quality of life (i.e. 5-level EQ-5D version) according to the number of comorbid anxiety disorders at baseline.
METHODS: This is a longitudinal secondary analysis of data collected up to 4-month posttreatment by Roberge et al. (2018, 2020) in a community-based pragmatic randomized controlled trial assessing the effectiveness of tCBT added to TAU (n=117) compared to TAU only (n=114) in a sample of individuals with DSM-5 anxiety disorders. Intervention: tCBT protocol for AD including 12 weekly group sessions addressing: psychoeducation, cognitive restructuring, exposure, schema-based cognitive restructuring and relapse prevention. Generalized Estimating Equation models were used with the EQ-5D-5L domain levels as ordinal variables. The number of comorbid anxiety disorders at baseline was assessed as a potential moderator of the impact of tCBT on health-related quality of life. Each domain was assessed separately.
RESULTS: Interaction main significant effects were observed between time and intervention group for the anxiety/depression (p<0.001) and the usual activities domains (p<0.001). However, there was no significant interaction between the intervention group and the number of comorbid anxiety disorders nor between time and number of comorbid anxiety disorders. Similar results were obtained for the EQ-5D-5L utility index and visual analog scale.
CONCLUSIONS: The evidence does not support a different effect of tCBT on health-related quality of life according to the presence multiple anxiety comorbidities, that is, anxiety multimorbidity does not modify the effect.
METHODS: This is a longitudinal secondary analysis of data collected up to 4-month posttreatment by Roberge et al. (2018, 2020) in a community-based pragmatic randomized controlled trial assessing the effectiveness of tCBT added to TAU (n=117) compared to TAU only (n=114) in a sample of individuals with DSM-5 anxiety disorders. Intervention: tCBT protocol for AD including 12 weekly group sessions addressing: psychoeducation, cognitive restructuring, exposure, schema-based cognitive restructuring and relapse prevention. Generalized Estimating Equation models were used with the EQ-5D-5L domain levels as ordinal variables. The number of comorbid anxiety disorders at baseline was assessed as a potential moderator of the impact of tCBT on health-related quality of life. Each domain was assessed separately.
RESULTS: Interaction main significant effects were observed between time and intervention group for the anxiety/depression (p<0.001) and the usual activities domains (p<0.001). However, there was no significant interaction between the intervention group and the number of comorbid anxiety disorders nor between time and number of comorbid anxiety disorders. Similar results were obtained for the EQ-5D-5L utility index and visual analog scale.
CONCLUSIONS: The evidence does not support a different effect of tCBT on health-related quality of life according to the presence multiple anxiety comorbidities, that is, anxiety multimorbidity does not modify the effect.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO2
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Mental Health (including addition)