Cost-effectiveness of transdiagnostic group cognitive behavioural therapy versus group relaxation therapy for emotional disorders in primary care (PsicAP-Costs2): Protocol for a multicentre randomised controlled trial.

Several randomised controlled trials (RCT) have demonstrated the superiority of transdiagnostic group cognitive-behavioural therapy (TD-CBT) to treatment as usual (TAU) for emotional disorders in primary care. To date, however, no RCTs have been conducted to compare TD-CBT to another active intervention in this setting. Our aim is to conduct a single-blind RCT to compare group TD-CBT plus TAU to progressive muscle relaxation (PMR) plus TAU in adults (age 18 to 65 years) with a suspected emotional disorder. We expect that TD-CBT + TAU will be more cost-effective than TAU + PMR, and that these gains will be maintained at the 12-month follow-up. Seven therapy sessions (1.5 hours each) will be offered over a 24-week period. The study will be carried out at four primary care centres in Cantabria, Spain. The study will take a societal perspective. Psychological assessments will be made at three time points: baseline, post-treatment, and at 12-months. The following variables will be evaluated: clinical symptoms (anxiety, depression, and/or somatic); functioning; quality of life (QoL); cognitive-emotional factors (rumination, worry, attentional and interpretative biases, emotion regulation and meta-cognitive beliefs); and satisfaction with treatment. Data on health service use, medications, and sick days will be obtained from electronic medical records. Primary outcome measures will include: incremental cost-effectiveness ratios (ICER) and incremental cost-utility ratios (ICURs). Secondary outcome measures will include: clinical symptoms, QoL, functioning, and treatment satisfaction. Bootstrap sampling will be used to assess uncertainty of the results. Secondary moderation and mediation analyses will be conducted. Two questionnaires will be administered at sessions 1, 4, and 7 to assess therapeutic alliance and group satisfaction. If this trial is successful, widespread application of this cost-effective treatment could greatly improve access to psychological treatment for emotional disorders in the context of increasing demand for mental healthcare in primary care. Trial registration: ClinicalTrials.gov: Cost-effectiveness of a Transdiagnostic Psychological Treatment for Emotional Disorders in Primary Care (PsicAP). NCT05314920.

Psychometric properties of the Mindful Attention Awareness Scale (MAAS) in a first-episode psychosis sample.

Despite the considerable growth in mindfulness-based research in the field of psychosis, few attempts have been made to validate mindfulness instruments in this population. This study aimed to evaluate the factorial structure, internal consistency, construct validity, and longitudinal measurement invariance of the Mindful Attention Awareness Scale (MAAS) in a sample of individuals with first-episode psychosis (FEP). In a sample of 150 individuals with remitted FEP, the present study explored the factor structure, measurement invariance, reliability, convergent and discriminant validity of the MAAS. Confirmatory factor analysis supported a single-factor solution, which showed temporal stability, excellent internal consistency reliability (Cronbach's α = .92; McDonald's ω = .93), and theoretically coherent convergent and discriminant validity with measures of well-being, satisfaction with life, savoring, self-compassion, depression, anxiety, stress, and positive symptoms. Overall, the psychometric properties of the MAAS were similar to those described in previous validation studies, thus supporting the value of this instrument to assess the dimension of attention and awareness to the present moment in individuals with FEP. (PsycInfo Database Record (c) 2022 APA, all rights reserved).