Terapia cognitivo-conductual transdiagnóstica en Atención Primaria: un contexto ideal
DOI:
https://doi.org/10.33898/rdp.v29i110.243Palabras clave:
terapia cognitivo-conductual, tratamiento transdiagnóstico, trastornos mentales comunes, ansiedad, atención primaria, depresiónResumen
La eficacia, efectividad y eficiencia de la Terapia Cognitivo-Conductual (TCC) para una amplia variedad de problemas psicológicos, particularmente para los trastornos de ansiedad y la depresión, cuenta con mayor apoyo empírico que ninguna otra forma de intervención psicológica. Sin embargo, sólo una pequeña parte de las personas con trastornos mentales comunes recibe un tratamiento adecuado. La expansión del enfoque transdiagnóstico en los trastornos mentales, especialmente en el contexto de Atención Primaria (AP), donde son tratados la mayor parte de las personas con trastornos mentales comunes, puede servir para facilitar el acceso a los tratamientos psicológicos eficaces. El estudio PsicAP es un ensayo clínico en curso para investigar la eficacia de la TCC transdiagnóstica grupal para tratar trastornos emocionales en el entorno de AP. Los resultados de este ensayo podrían servir para promover el uso de tratamientos psicológicos para los trastornos mentales más prevalentes en AP, según lo recomendado por las guías clínicas basadas en la evidencia.Descargas
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Addis, M. E. y Krasnow, A. D. (2000). A national survey of practicing psychologists' attitudes toward psychotherapy treatment manuals. Journal of consulting and clinical psychology, 68(2), 331-339. doi:10.1037/0022-006X.68.2.331
Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., De Girolamo, G., de Graaf, R., Demyttenaere, K., Gasquet, I., Haro, J., Katz, S., Kessler, R., Koves, V., Lépine, J., Ormel, J., Polidori, G., Russo, L., Vilagut, G., Almansa, J., Arbabzadeh-Bouchez, S., Autonell, J., Bernal, M., Boust-Bouwman, M., Codony, M., Domingo-Salvany, A., Ferrer, M., Joo, S., Martínez-Alonso, M., Matschinger, H., Mazzi, F., Morgan, Z., Morosini, P., Palacín, C., Romera, B., Taub, N. y Vollebergh, W. (2004). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta psychiatrica scandinavica, 109 (s420), 21-27. doi:10.1111/j.1600-0047.2004.00327.x
Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L. y Newby, J. M. (2018). Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: An updated meta-analysis. Journal of anxiety disorders, in press. Recuperado de: https://www.sciencedirect.com/science/article/pii/S0887618517304474?via%3Dihub
Autonell, J., Vila, F., Pinto-Meza, A., Vilagut, G., Codony, M., Almansa, J y Haro, J. M. (2007). One year prevalence of mental disorders comorbidity and associated socio-demographic risk factors in the general population of Spain. Results of the ESEMeD-Spain study. Actas españolas de psiquiatría, 35, 4-11.
Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B. y Ehreinreich-May, J. (2011). Unified protocol for transdiagnostic treatment of emotional disorders. New York, NY: Oxford University Press. doi:10.1016/j.beth.2012.01.001
Barlow, D. H., Allen, L. B. y Choate, M. L. (2016). Toward a Unified Treatment for Emotional Disorders–Republished Article. Behavior therapy, 47(6), 838-853. doi:0.1016/j.beth.2016.11.005
Bortolotti, B., Menchetti, M., Bellini, F., Montaguti, M. B. y Berardi, D. (2008). Psychological interventions for major depression in primary care: a meta-analytic review of randomized controlled trials. General hospital psychiatry, 30(4), 293-302. doi:10.1016/j.genhosppsych.2008.04.001
Brown, T. A. y Barlow, D. H. (2009). A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: Implications for assessment and treatment. Psychological assessment, 21(3), 256-271. doi:10.1037/a0016608
Bullis, J. R., Fortune, M. R., Farchione, T. J. y Barlow, D. H. (2014). A preliminary investigation of the long-term outcome of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Comprehensive psychiatry, 55(8), 1920-1927. doi:10.1016/j.comppsych.2014.07.016
Butler, A. C., Chapman, J. E., Forman, E. M. y Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychological Review, 26(1), 17-31. doi:10.1016/j.cpr.2005.07.003
Cano-Vindel, A., Muñoz-Navarro, R., Wood, C. M., Limonero, J. T., Medrano, L. A., Ruiz-Rodríguez, P. y Santolaya, F. (2016). Transdiagnostic cognitive behavioral therapy versus treatment as usual in adult patients with emotional disorders in the primary care setting (PsicAP study): protocol for a randomized controlled trial. JMIR research protocols, 5(4). doi:10.2196/resprot.6351
Cape, J., Whittington, C., Buszewicz, M., Wallace, P. y Underwood, L. (2010). Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta-regression. BMC medicine, 8(1), 38. doi:10.1186/1741-7015-8-38
Ciraulo, D. A., Barlow, D. H., Gulliver, S. B., Farchione, T., Morissette, S. B., Kamholz, B. W., Esenmenger, K., Brown, B., Devine, E., Brown, T. A. y Knapp, C. M. (2013). The effects of venlafaxine and cognitive behavioral therapy alone and combined in the treatment of co-morbid alcohol use-anxiety disorders.. Behaviour Research and Therapy, 51(11), 729-735. doi:0.1016/j.brat.2013.08.003
Codony, M., Alonso, J., Almansa, J., Vilagut, G., Domingo, A., Pinto-Meza, A., Fernández, A., Usall, J., Dolz, M. y Haro, J. M. (2007). Utilización de los servicios de salud mental en la población general española. Resultados del estudio ESEMeD-España. Actas Españolas de Psiquiatrı́a, 35(2), 21-28.
Codony, M., Domingo-Salvany, A., Ferrer, M., Joo, S., Martínez-Alonso, M., Matschinger, H., Mazzi, F., Morgan, Z., Morosini, P., Palacín, C., Romera, B., Taub, N. y Vollebergh, W. (2004). Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta psychiatrica scandinavica, 109(s420), 21-27. doi:10.1111/j.1600-0047.2004.00327.x
Cordero-Andrés, P., González-Blanch, C., Umaran-Alfageme, O., Muñoz-Navarro, R., Ruíz-Rodríguez, P., Medrano, L. A., … Cano-Vindel, A. (2017). Tratamiento psicológico de los trastornos emocionales en atención primaria: fundamentos teóricos y empíricos del estudio PsicAP. Ansiedad y Estrés, 23(2–3), 91–98. doi:10.1016/j.anyes.2017.10.004
Cuijpers, P., van Straten, A. y Warmerdam, L. (2008). Are individual and group treatments equally effective in the treatment of depression in adults? a meta-analysis. The European Journal of Psychiatry, 22(1), 38-51. Recuperado de: http://scielo.isciii.es/pdf/ejpen/v22n1/original3.pdf
Cuijpers, P., van Straten, A., van Schaik, A. y Andersson, G. (2009). Psychological treatment of depression in primary care: a meta-analysis. British Journal of General Practice, 59(559), e51-e60. doi:10.3399/bjgp09X395139
De Ornelas Maia, A. C. C., Nardi, A. E. y Cardoso, A. (2015). The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial. Journal of affective disorders, 172, 179-183. doi:10.1016/j.jad.2014.09.023
Dear, B. F., Staples, L. G., Terides, M. D., Karin, E., Zou, J., Johnston, L y Titov, N. (2015). Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial. Journal of Anxiety Disorders, 36, 63-77. doi:10.1016/j.janxdis.2015.09.003
Dear, B. F., Staples, L. G., Terides, M. D., Fogliati, V. J., Sheehan, J., Johnston, L., Kayrouz, R., Dear, R., McEvoy, P. M. y Titov, N. (2016). Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for Social Anxiety Disorder and comorbid disorders: A randomized controlled trial. Journal of Anxiety Disorders, 42, 30-44. doi:0.1016/j.janxdis.2016.03.005
Deveugele, M, Derese, A., van den Brink-Muinen, A., Bensing, J. y De Maeseneer, J. (2002). Consultation length in general practice: cross sectional study in six European countries. British Medical Journal, 325 (7362), 472.
Dixon, L. B., Dickerson, F., Bellack, A. S., Bennett, M., Dickinson, D. y Goldberg, R. W, Schizophrenia Patient Outcomes Research Team (PORT). (2010). The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophrenia Bulletin, 36, 48-70. doi:10.1093/schbul/sbp115
Dwyer, L., Olsen, S. y Oei, T. P. S. (2013). Cognitive-behavioral group therapy for heterogeneous anxiety and mood disorders in a psychiatric hospital outpatient clinic. Journal of Cognitive Psychotherapy, 27(2), 138-154. doi:10.1891/0889-8391.27.2.138
Ejeby, K., Savitskij, R., Öst, L. G., Ekbom, A., Brandt, L., Ramnerö, J., Asberg, M. y Backlund, L. G. (2014). Randomized controlled trial of transdiagnostic group treatments for primary care patients with common mental disorders. Family practice, 31(3), 273-280. doi:10.1093/fampra/cmu006
Ellard, K. K., Fairholme, C. P., Boisseau, C. L., Farchione, T. J. y Barlow, D. H. (2010). Unified protocol for the transdiagnostic treatment of emotional disorders: Protocol development and initial outcome data. Cognitive and Behavioral Practice, 17(1), 88-101. doi:10.1016/j.cbpra.2009.06.002
Erickson, D. H., Janeck, A. S. y Tallman, K. (2007). A cognitive-behavioral group for patients with various anxiety disorders. Psychiatric Services, 58(9), 1205-1211. doi:10.1176/ps.2007.58.9.1205
Fairburn, C. G., Cooper, Z. y Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment.. Behaviour Research and Therapy, 41(5), 509-528. doi:10.1016/S0005-7967(02)00088-8
Fairburn, C. G. (2008). Eating disorders: The transdiagnostic view and the cognitive behavioral therapy. En C. Fairburn (Ed.). Cognitive behavior therapy and eating disorder. New York, NY: Guilford Press. doi:10.1016/j.brat.2008.06.012
Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Thompson-Hollands, J., Carl, J. R. y Barlow, D. H. (2012). Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behavior therapy, 43(3), 666-678. doi:10.1016/j.beth.2012.01.001
Fernández, A., Pinto-Meza, A., Bellón, J. A., Roura-Poch, P., Haro, J. M., Autonell, J., Palao, D. J., Peñarrubia, M. T., Fernández, R., Blanco, E., Luciano, J. V. y Serrano-Blanco, A. (2010). Is major depression adequately diagnosed and treated by general practitioners? Results from an epidemiological study. General Hospita Psychiatry, 32(2), 201-209. doi: 10.1016/j.genhosppsych.2009.11.015
Serrano-Blanco, A. (2010). Is major depression adequately diagnosed and treated by general practitioners? Results from an epidemiological study. General Hospital Psychiatry, 32(2), 201-209. doi:10.1016/j.genhosppsych.2009.11.015
Fernández, A., Rubio-Valera, M., Bellón, J. A., Pinto-Meza, A., Luciano, J. V., Mendive, J. M., Haro, J. M., Palao, D. J. y Serrano-Blanco, A. (2012). Recognition of anxiety disorders by the general practitioner: results from the DASMAP study. General Hospital Psychiatry, 34(3), 227-233. doi:10.1192/bjp.bp.111.096305
Fogliati, V. J., Dear, B. F., Staples, L. G., Terides, M. D., Sheehan, J., Johnston, L., Kayrouz, R., Dear, R., McEvoy, P. M. y Titov, N. (2016). Disorder-specific versus transdiagnostic and clinician-guided versus self-guided internet-delivered treatment for panic disorder and comorbid disorders: A randomized controlled trial. Journal of Anxiety Disorders, 39, 88-102. doi:10.1016/j.janxdis.2016.03.005
Gaudiano, B. A. y Miller, I. W. (2013). The evidence-based practice of psychotherapy:Facing the challenges that lie ahead. Clinical Psychology Review, 33, 813-824.
Gili, M., Roca, M., Basu, S., McKee, M. y Stuckler, D. (2013). The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010. European Journal of Public Health, 23(1), 103-108. doi:10.1016/j.cpr.2013.04.004
González-Blanch, C. y Carral-Fernández, L. (2017). ¡Enjaulad a Dodo, por favor! El cuento de que todas las psicoterapias son igual de eficaces. Papeles del Psicólogo, 38(2), 94-106. doi:10.23923/pap.psicol2017.2828
González-Blanch, C., Umaran-Alfageme, O., Cordero-Andrés, P., Muñoz-Navarro, R., Ruiz-Rodríguez, P., Medrano, L. A., Ruíz-Torres, M., Collado, E. D. y Cano-Vindel, A. (2017). Tratamiento psicológico de los trastornos emocionales en Atención Primaria: el manual de tratamiento transdiagnóstico del estudio PsicAP. Ansiedad y Estrés 24(1), 1-11. doi:10.1016/j.anyes.2017.10.005
Haller, H., Cramer, H., Lauche, R., Gass, F. y Dobos, G. J. (2014). The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review. BMC psychiatry, 14(1), 128. doi:10.1186/1471-244X-14-128
Hamblen, J. L., Norris, F. H., Symon, K. A. y Bow, T. E. (2017). Cognitive behavioral therapy for postdisaster distress: A promising transdiagnostic approach to treating disaster survivors. Psychological Trauma, Suppl 1, 130-136. doi:0.1037/tra0000221
Hazell, C. M., Hayward, M., Cavanagh, K., Jones, A. M. y Strauss, C. (2017). Guided self-help cognitive-behaviour Intervention for VoicEs (GiVE): Results from a pilot randomised controlled trial in a transdiagnostic sample. Schizophrenia Research, 195, 441-447. doi:0.1016/j.schres.2017.10.004
Hinton, D. E. y Patel, A. (2017). Cultural Adaptations of Cognitive Behavioral Therapy. Psychiatric Clinics of North America, 40(4), 701-714. doi:10.1016/j.psc.2017.08. 006
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T. y Fang, A. (2012). The effi cacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440. doi:10.1007/s10608-012-9476-1
Hollon, S. D., Stewart, M. O. y Strunk, D. (2006). Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annual Review of Psychology, 57, 285-315. doi:10.1146/annurev.psych.57.102904.190044
Hunsley, J. y Lee, C.M. (2007). Research-informed benchmarks for psychological treatments: Efficacy studies, effectiveness studies, and beyond. Professional Psychology: Research and Practice, 38, 21-33. doi:10.1037/0735-7028.38.1.21
Huntley, A. L., Araya, R. y Salisbury, C. (2012). Group psychological therapies for depression in the community: systematic review and meta-analysis. The British Journal of Psychiatry, 200(3), 184-190. doi:10.1192/bjp.bp.111.092049
Ilyas, S. y Moncrieff, J (2012). Trends in prescriptions and costs of drugs for mental disorders in England, 1998–2010. British Journal of Psychiatry 200, 393–398. doi:10.1192/bjp.bp.111.104257
INE. (2015). Encuesta Europea de salud en España (EESE 2014). Recuperado de: http://www.msssi.gob.es/estadEstudios/estadisticas/EncuestaEuropea/Enc_Eur_Salud_en_Esp_2014.htm
Infocop (2017). Cada vez más Comunidades Autónomas se suman a la demanda de psicólogos en AP. Infocop Online. Recuperado de: http://www.infocop.es/view_article.asp?id=6563&cat=44).
Infocop (2018a). Cataluña comienza a incorporar psicólogos clínicos en Atención Primaria. Infocop Online. Recuperado de: http://www.infocop.es/view_article.asp?id=7323.
Infocop (2018b). El próximo 19 de marzo empiezan a trabajar 21 psicólogos en los centros de salud madrileños. Infocop Online. Recuperado de: http://www.infocop.es/view_article.asp?id=7344&cat=44.
Infocop (2018c). La presencia del psicólogo en Atención Primaria facilita el acceso a tratamientos psicológicos- Entrevista a Natalia López. Infocop Online. Recuperado de: http://www.infocop.es/view_article.asp?id=7362&cat=44.
Judd, L. L., Schettler, P. J. y Akiskal, H. S. (2002). The prevalence, clinical relevance, and public health significance of subthreshold depressions. Psychiatric Clinics, 25(4), 685-698. doi:10.1016/S0193-953X(02)00026-6
Kolovos, S., Kleiboer, A. y Cuijpers, P. (2016). Effect of psychotherapy for depression on quality of life: meta-analysis. The British Journal of Psychiatry, 209(6), 460-468. doi:10.1192/bjp.bp.115.175059
Kristjánsdóttir, H., Salkovskis, P. M., Sigurdsson, B. H., Sigurdsson, E., Agnarsdóttir, A. y Sigurdsson, J. F. (2016). Transdiagnostic cognitive behavioural treatment and the impact of co-morbidity: An open trial in a cohort of primary care patients. Nordic journal of psychiatry, 70(3), 215-223. doi:10.3109/08039488.2015.1081404
Latorre Postigo, J. M., López-Torres Hidalgo, J., Montañés Rodríguez, J. y Parra Delgado, M. (2005). Percepción de la demanda y necesidades de formación en salud mental de los médicos de atención primaria. Atención Primaria, 36(2), 85-92. doi:10.1157/13076608
Linde, K., Sigterman, K., Kriston, L., Rücker, G., Jamil, S., Meissner, K. y Schneider, A. (2015). Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis. Annals of Family Medicine, 13(1), 56-68. doi:10.1370/afm.1719
López, C., Serrano, R. M., Valverde, A., Casabella, B. y Mundet, X. (2006). ¿Quién controla a los enfermos tratados con psicótropos en atención primaria? Atención Primaria, 37, 446-451. doi:0.1157/13088884
Mansell, W., Harvey, A., Watkins, E. y Shafran, R. (2009). Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy: An International Quarterly, 23(1), 6-19. doi:10.1891/0889-8391.23.1.6
McEvoy, P. M. y Mahoney, A. E. J. (2012). To be sure, to be sure: Intolerance to uncertainty mediates symptoms of various anxiety disorders and depression. Behaviour Therapy, 43, 533-545. doi:10.1016/j.beth.2011.02.007
McEvoy, P. M., Nathan, P. y Norton, P. J. (2009). Efficacy of transdiagnostic treatments: A review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy, 23(1), 20-33. doi:10.1891/0889-8391.23.1.20
Mewton, L., Hobbs, M. J., Sunderland, M., Newby, J. y Andrews, G. (2014). Reductions in the internalising construct following internet-delivered treatment for anxiety and depression in primary care. Behaviour research and therapy, 63, 132-138. doi:10.1016/j.brat.2014.10.001
Miklowitz, D. J. (2008). Adjunctive psychotherapy for bipolar disorder: State of the evidence. The American Journal of Psychiatry, 165, 1408-1419. doi:10.1176/appi.ajp.2008.08040488
Mojtabai, R. y Olfson, M. (2010). National trends in psychotropic medication polypharmacy in office-based psychiatry. Archives of General Psychiatry, 67, 26-36. doi:10.1001/archgenpsychiatry.2009.175
Morrison, N. (2001). Group cognitive therapy: treatment of choice or sub-optimal option?. Behavioural and Cognitive Psychotherapy, 29(3), 311-332. doi:10.1017/S1352465801003058
Mukuria, C., Brazier, J., Barkham, M., Connell, J., Hardy, G., Hutten, R., Saxon, D., Dent-Brown, K. y Parry, G. (2013). Cost-effectiveness of an improving access to psychological therapies service. The British Journal of Psychiatry, 202(3), 220-227. doi:10.1192/bjp.bp.111.107888
Muñoz-Navarro, R., Cano-Vindel, A., Ruiz-Rodríguez, P., Medrano, L. A., González-Blanch, C., Moriana, J. A., Capafons, A. y Dongil-Collado, E. (2017). Modelo jerárquico de diagnóstico y derivación de los trastornos mentales comunes en centros de atención primaria. Una propuesta a partir del ensayo clínico PsicAP. Ansiedad y Estrés, 23(4), 124-129. doi:10.1016/j.anyes.2017.10.002
NICE. (2011). Common Mental Health Disorders. Leicester (UK): British Psychological Society. Recuperado de: http://www.ncbi.nlm.nih.gov/books/NBK92266/.
Newby, J. M., McKinnon, A., Kuyken, W., Gilbody, S. y Dalgleish, T. (2015). Systematic review and meta-analysis of transdiagnostic psychological treatments for anxiety and depressive disorders in adulthood. Clinical Psychology Review, 40, 91-110. doi:10.1016/j.cpr.2015.06.002
Newby, J. M., Twomey, C., Yuan Li, S. S. y Andrews, G. (2016). Transdiagnostic computerised cognitive behavioural therapy for depression and anxiety: A systematic review and meta-analysis. Journal of Affective Disorders, 199, 30-41. doi:10.1016/j.jad.2016.03.018
Nordgren, L. B., Hedman, E., Etienne, J., Bodin, J., Kadowaki, A., Eriksson, S., Lindkvist, E., Andersson, G. y Carlbring, P. (2014). Effectiveness and cost-effectiveness of individually tailored Internet-delivered cognitive behavior therapy for anxiety disorders in a primary care population: A randomized controlled trial. Behaviour Research and Therapy, 59, 1-11. doi:10.1016/j.brat.2014.05.007
Norton, P. J. (2008). An open trial of a transdiagnostic cognitive-behavioral group therapy for anxiety disorder. Behavior Therapy, 39(3), 242-250. doi:10.1016/j.beth.2007.08.002
Norton, P. J., Barrera, T. L., Mathew, A. R., Chamberlain, L. D., Szafranski, D. D., Reddy, R. y Smith, A. H. (2013). Effect of transdiagnostic CBT for anxiety disorders on comorbid diagnoses. Depression and Anxiety, 30(2), 168-173. doi:10.1002/da.22018
OECD. (2018). OECD Health Data: Pharmaceutical market, OECD Health Statistics (database). Recuperado de: http://stats.oecd.org/index.aspx?r=512151#
Oei, T. P., y Dingle, G. (2008). The effectiveness of group cognitive behaviour therapy for unipolar depressive disorders. Journal of Affective Disorders, 107(1), 5-21. doi:10.1016/j.jad.2007.07.018
Olatunji, B. O., & Hollon, S. D. (2010). Preface: the current status of cognitive behavioral therapy for psychiatric disorders. Psychiatric Clinics, 33(3), xiii-xix. doi:10.1016/j.psc.2010.04.015
Olfson, M. & Marcus, S. C. (2010). National trends in outpatient psychotherapy. The American Journal of Psychiatry, 167, 1456-1463. doi:10.1176/appi.ajp. 2010.10040570
Ophuis, R. H., Lokkerbol, J., Heemskerk, S. C., van Balkom, A. J., Hiligsmann, M. y Evers, S. M. (2017). Cost-effectiveness of interventions for treating anxiety disorders: A systematic review. Journal of affective disorders, 210, 1-13. doi:10.1016/j.jad.2016.12.0057
Pearl, S. B. y Norton, P. J. (2017). Transdiagnostic versus diagnosis specific cognitive behavioural therapies for anxiety: A meta-analysis. Journal of anxiety disorders, 46, 11-24. doi:10.1016/j.janxdis.2016.07.004
Prins, M. A., Verhaak, P. F., Bensing, J. M. y Van der Meer, K. (2008). Health beliefs and perceived need for mental health care of anxiety and depression—The patients' perspective explored. Clinical Psychology Review, 28, 1038-1058. doi:10.1016/j.cpr.2008.02.009
Reinholt, N. y Krogh, J. (2014). Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: A systematic review and meta-analysis of published outcome studies. Cognitive Behaviour Therapy, 43(3), 171-184. doi:10.1080/16506073.2014.897367
Reinholt, N., Aharoni, R., Winding, C., Rosenberg, N., Rosenbaum, B. y Arnfred, S. (2017). Transdiagnostic group CBT for anxiety disorders: the unified protocol in mental health services. Cognitive behaviour therapy, 46(1), 29-43. doi:10.1080/16506073.2016.1227360
Richards, D. A. y Suckling, R. (2009). Improving access to psychological therapies: Phase IV prospective cohort study. British Journal of Clinical Psychology, 48(4), 377-396. doi:10.1348/014466509X405178
Roca, M., Gili, M., García-García, M., Salva, J., Vives, M, García Campayo, J. y Comas, A. (2009). Prevalence and comorbidity of common mental disorders in primary care. Journal of Affective Disorders, 119 (1-3), 52-8. doi:10.1016/j.jad.2009.03.014
Sandín, B. (2012). Transdiagnóstico y psicología clínica: Introducción al número monográfico. Revista de Psicopatología y Psicología Clínica, 17, 181-184.
Schmidt, N. B., Buckner, J. D., Pusser, A., Woolaway-Bickel, K., Preston, J. L. y Norr, A. (2012). Randomized controlled trial of false safety behavior elimination therapy: A unified cognitive behavioral treatment for anxiety psychopathology. Behavior Therapy, 43(3), 518-532. doi:10.1016/j.beth.2012.02.004
Seekles, W., Cuijpers, P., Kok, R., Beekman, A., van Marwijk, H. y van Straten, A. (2013). Psychological treatment of anxiety in primary care: a meta-analysis. Psychological medicine, 43(2), 351-361. doi:10.1017/S0033291712000670
Stewart, R. E., Chambless, D. L. y Baron, J. (2012). Theoretical and practical barriers to practitioners' willingness to seek training in empirically supported treatments. Journal of Clinical Psychology, 68(1), 8-23. doi:10.1002/jclp.20832
Sukhodolsky, D. G., Smith, S. D., McCauley, S. A., Ibrahim, K. y Piasecka, J. B. (2016). Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents. Journal of Child and Adolescent Psychopharmacology, 26(1), 58-64. doi:10.1089/cap.2015.0120
Talkovsky, A. M., Green, K. L., Osegueda, A. y Norton, P. J. (2017). Secondary depression in transdiagnostic group cognitive behavioral therapy among individuals diagnosed with anxiety disorders. Journal of anxiety disorders, 46, 56-64. doi:10.1016/j.janxdis.2016.09.008
Titov, N., Dear, B. F., Staples, L. G., Terides, M. D., Karin, E., Sheehan, J., Johnston, L., Gandy, M., Fogliati, V. J., Wootton, B. M. y McEvoy, P. M. (2015). Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial. Journal of Anxiety Disorders, 35, 88-102. doi:10.1016/j.janxdis.2015.08.002
Turner, H., Marshall, E., Stopa, L. y Waller, G. (2015). Cognitive-behavioural therapy for outpatients with eating disorders: effectiveness for a transdiagnostic group in a routine clinical setting. Behaviour Research and Therapy, 68, 70-75. doi:10.1016/j.brat.2015.03.001
Twomey, C., O'Reilly, G. y Byrne, M. (2015) Effectiveness of cognitive behavioural therapy for anxiety and depression in primary care: a meta-analysis. Family Practice, 32(1), 3-15. doi:10.1093/fampra/cmu060
Vujanovic, A. A., Meyer, T. D., Heads, A. M., Stotts, A. L., Villarreal, Y. R. y Schmitz, J. M. (2017). Cognitive-behavioral therapies for depression and substance use disorders: An overview of traditional, third-wave, and transdiagnostic approaches. American Journal of Drug and Alcohol Abuse, 43(4), 402-415. doi:10.1080/00952990.2016.1199697
Wade, S., Byrne, S. y Allen, K. (2017). Enhanced cognitive behavioral therapy for eating disorders adapted for a group setting. International Journal of Eating Disorders, 50(8), 863-872. doi:10.1002/eat.22723
Westbrook, D. y Kirk, J. (2005). The clinical effectiveness of cognitive behaviour therapy: Outcome for a large sample of adults treated in routine practice. Behaviour Research and Therapy, 43, 1243-1261. doi:10.1016/j.brat.2004.09.006
Widiger, T. A., y Samuel, D. B. (2005). Diagnostic categories or dimensions? A question for the Diagnostic and statistical manual of mental disorders. Journal of abnormal psychology, 114(4), 494-504. doi:0.1037/0021-843X.114.4.494