Intensive Short-Term Dynamic Psychotherapy (ISTDP) for Anxiety Diagnoses in a Primary Care Setting

Study Overview
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Brief Summary
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Living with anxiety often means great suffering for the person affected. The trend points to a continued increase in anxiety problems in the population, especially in the 18-44 age group. Inadequate treatment of this condition can lead to long-term sick leave, isolation, exclusion and, in the worst case, to death. The treatment methods that are available in primary care today help some but far from all. Therefore, the investigators want to scientifically evaluate a shorter version of a proven emotion-focused psychotherapy in order to increase the treatment range for this patient group. The aim of this project is to, in a primary care setting, test and evaluate an intensive, emotion-focused short-term therapy, ISTDP (Intensive Short-Term Dynamic Psychotherapy) for patients with an anxiety diagnosis. The method is well-proven on patients with more severe mental conditions (personality disorders) with good results, but the treatment has only been tested to a limited extent on patients with anxiety symptoms. The investigators want to investigate the effectiveness of treating various anxiety states for primary care patients. The treatment is expected to provide an addition to today's methods, which overall will provide better treatment results for this, increasing in number, group of patients who often seek primary care.

Official Title
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Anxiety Treatment in Primary Care: an Evaluation of Intensive Dynamic Short-term Therapy

Conditions
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Psychotherapy, Anxiety Disorders, Psychiatric &or Mood Disorder

Intervention / Treatment
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* Other: Intensive Short-Term Dynamic Psychotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary Care patients with primary anxiety diagnoses at a Health Care clinic in Sweden. Sufficient language competence in Swedish is required of the participants to understand, read, speak and write. Exclusion Criteria: Major reading-writing and learning difficulties, severe psychiatric problems such as psychosis, eating disorder, current major depression, recurrent depression, severe trauma, acute crisis reaction, exhaustion, acute risk of suicide (assessed according to the suicide scale), addiction. Diagnosed specific phobia or obsessive-compulsive disorder that must be primarily treated with CBT. Concurrent psychological treatment, anxiety-relieving medication such as benzodiazepines, or recently started antidepressant treatment (< 3 months of treatment) are also exclusion criteria for participation in the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Controlled study; participants (e.g. primary care patients with an anxiety disorder) will be recruited consecutively to the study, they will be put on a waiting-list for 3 months (= standard procedure) and thus be their own control person.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treated<br>Participants are their own controls when they are on the waiting list before treatment, and they will later be treated with the ISTDP. | Other: Intensive Short-Term Dynamic Psychotherapy<br>* A dynamic and intensive psychotherapy with eight therapeutic sessions<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Generalized Anxiety Disorder-7 (GAD-7) scorings | Self-report measure. The GAD-7 consists of 7 items which are scored 0-3, with a total score ranging from 0-21. Higher scores correspond to worse outcome. measures | Changes in scorings from baseline scorings to scorings after 9-10 months. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Perceived Health Questionnaire (PHQ-9) scorings | Self-report measure. The PHQ-9 consists of 9 items, which are scored from 0-3 and a total score ranging from 0-27. Higher scores correspond to worse outcome. | Changes in scorings from baseline scorings to scorings after 9-10 months. | 
| The Panic Disorder Severity Scale (PDSS) scorings | Self-report measure. The PDSS consists of 7 items, which are scored from 0-4, with a total score ranging from 0-28. Higher scores correspond to worse outcome. | Changes in scorings from baseline scorings to scorings after 9-10 months. | 
| The Brunnsvikens Brief Quality of Life Inventory (BBQ) scorings | Self-report measure. The BBQ has a total of 12 items covering 6 life areas. Possible total score range is 0-96. Higher scores correspond to a better outcome. | Changes in scorings from baseline scorings to scorings after 9-10 months. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Anxiety Disorders, Primary Care Setting, Psychotherapy, Clinical Research