Depression & Anxiety: Transdiagnostic Psychotherapy

Pim Cuijpers

, Clara Miguel

, Marketa Ciharova

, David Ebert

, Mathias Harrer

, Eirini Karyotaki

General Description

The depression-anxiety-transdiagnostic dataset is part of the meta-analytic research domain (MARD) on psychotherapy for depression/anxiety. This MARD is part of the Metapsy project. The dataset contains study information and effect size data of transdiagnostic psychological interventions for depression and anxiety.

This dataset includes psychotherapy vs. control (psy vs ctr) comparisons. Effect sizes are provided for depression and anxiety outcomes at post-test. It includes one type of effect size calculation per study, giving priority to means and standard deviations at post-test, followed by change scores, binary outcomes, and other statistics.

The dataset follows the Metapsy data standard. All included information has been independently extracted two researchers. Risk of bias ratings were conducted using the Cochrane Collaboration Risk of Bias Tool (Version 1).

Affiliated Institutions

Vrije Universiteit Amsterdam, Technical University Munich

Online Meta-Analysis Tool

A simplified version of this database can be analyzed at metapsy.org/database/transdiagnostic-depression-anxiety.

Metadata

metapsyData Shorthand: depression-anxiety-transdiagnostic
Number of Studies: 45
Latest Version: 22.0.5
Last updated: October 24, 2022
Last search: January 1, 2022
Search String (Latest Version): ↗
Data Repository (Latest Version): ↗
Preregistration (Research Domain): ↗
License: ODC-By v1.0 ↗
Database DOI:

Version 22.0.5 (October 24, 2022):
Version 22.0.4 (October 24, 2022):
Version 22.0.3 (October 24, 2022):
Version 22.0.2 (October 24, 2022):
Version 22.0.1 (October 24, 2022):

Variable Description

Variable	Description
`study`	Author and year of publication
`condition_arm1`	Type of treatment (cbt= cognitive behaviour therapy, bat= behavioural activation, pst= problem solving therapy, ipt= interpersonal psychotherapy, dyn= psychodynamic therapy, lrt= life review therapy, other psy= other type of psychotherapy)
`condition_arm2`	Type of comparator (cau= care as usual, wl= waitlist, pha= pharmacological treatment, other ctr= other type of inactive control grou, sup= supportive counseling, other psy= other type of psychotherapy )
`multi_arm1`	In multiarm trials, this variable provides a specification of the type of treatment used in the first arm. This variable is set to NA (missing) when the study was not a multiarm trial. For example, if a multiarm trial employed two types of CBT interventions, face-to-face and Internet-based, this variable would be set to f2f and Internet, respectively.
`multi_arm2`	In multiarm trials, this variable provides a specification of the type of treatment used in the second arm. This variable is set to NA (missing) when the study was not a multiarm trial. For example, if a multiarm trial employed two types of control groups, waitlist and placebo, this variable would be set to wl and plac, respectively. Typically, multiarm trials employ two or more active treatments (e.g. CBT and problem-solving therapy), which are compared to the same control group (e.g. a waitlist). This means that values in multi_arm2 do not differ (e.g. they are always wl for this specific multiarm trial); nevertheless, the variable should be specified in the dataset.
`outcome_type`	This variable encodes the type of outcome that builds the basis of the comparison, e.g. means and standard deviations (msd), change from baseline, response, remission, other statistics, etc.
`sample`	Indicates whether the extracted data is obtained from intention to treat estimates or from observed data.
`instrument`	This variable describes the instrument through which the relevant outcome was measured.
`time`	The measurement point at which the outcome was obtained (e.g. post or follow-up).
`rating`	This variable encodes if the measured outcome was self-reported ("self-report") or clinician-rated ("clinician").
`depanx`	Indicates whether the effect size is calculated based on anxiety, depression, or mixed anxiety and depression measures
`mean_arm1`	Mean arm 1
`mean_arm2`	Mean arm 2
`sd_arm1`	Standard deviation arm 1
`sd_arm2`	Standard deviation arm 2
`n_arm1`	Number of participants arm 1
`n_arm2`	Number of participants arm 2
`mean_change_arm1`	Mean change from baseline arm 1
`mean_change_arm2`	Mean change from baseline arm 2
`sd_change_arm1`	Standard deviation for the change from baseline arm 1
`sd_change_arm2`	Standard deviation for the change from baseline arm 2
`n_change_arm1`	Number of participants arm 1 (change scores)
`n_change_arm2`	Number of participants arm 2 (change scores)
`event_arm1`	Number of events (responders, remission, deterioration cases) in the first trial arm
`event_arm2`	Number of events (responders, remission, deterioration cases) in the second trial arm
`totaln_arm1`	Total number of participants arm 1 (event data). Randomized sample.
`totaln_arm2`	Total number of participants arm 2 (event data). Randomized sample.
`precalc_g`	The pre-calculated value of Hedges' g (small-sample bias corrected standardized mean difference; Hedges, 1981).
`precalc_g_se`	Standard error of g
`precalc_log_rr`	The pre-calculated value of the log-risk ratio logeRR, comparing events in the first arm to events in the second arm.
`precalc_log_rr_se`	The standard error of the log-risk ratio logeRR, comparing events in the first arm to events in the second arm.
`baseline_m_arm1`	Baseline mean arm 1
`baseline_sd_arm1`	Baseline standard deviation arm 1
`baseline_n_arm1`	Number of participants at baseline arm 1
`baseline_m_arm2`	Baseline mean arm 2
`baseline_sd_arm2`	Baseline standard deviation arm 2
`baseline_n_arm2`	Number of participants at baseline arm 2
`dich`	Exact definition of the dichotomous outcome as provided in the publication: e.g."remission based on bdi-II<=8 and ham-d<=7"
`dich_type`	Broader categories of dichotomous outcomes: remission, response, etc.
`time_weeks`	The measurement point at which the outcome was obtained, in weeks after randomization (set to NA if this information was not available).
`year`	Year of publication
`comorbid_mental`	All the participants are recruited based on meeting criteria for a comorbid mental health disorder (e.g. anxiety and depression). Coded as y= yes, n= no
`format`	ind= individual; grp= group; gsh= guided self-help; tel= telephone; cpl= couple therapy; oth= other (mixed formats); ush= unguided self-help
`format_details`	It includes more details about the format, when necessary
`n_sessions_ig`	Average number of sessions received
`country`	us= USA; uk= United Kingdom; eu= Europe; can= Canada; au= australia; eas= east asia; oth= other
`age_group`	adul= adults, 5= older adults (≥55 years); old= older old adults (≥75 years)
`mean_age`	Average age
`percent_women`	% of women at baseline
`recruitment`	com= community; clin= clinical; oth= other
`diagnosis`	mdd= major depression; mood= mood disorder; cut= cut-off score; sub= subclinical depression;chr= chronic depression
`target_group`	adul= adults, old= older adults, stud= student population, ppd= women with perinatal depression; med= comorbid medical disorder; oth= other
`ac`	Allocation concealment (0= high risk; 1= low risk)
`sg`	Sequence generation (0= high risk; 1= low risk)
`ba`	Blinding of assessors (0= high risk; 1= low risk; sr= self-report)
`itt`	Intention-to-treat analyses (0= high risk; 1= low risk)
`rob`	Overall risk of bias score. ranging from 0 (high risk) to 4 (low risk)
`no.arms`	Number of arms with the same measurement instrument within a study
`is.multiarm`	0= no, 1= yes
`primary`	One primary outcome per study, based on a predefined hierarchy: HAM-D, BDI (I or II), another clinician-rated instrument, another self-report instrument, with priority for: PHQ-9, CES-D, HADS, GDS, EPDS, MMPI
`primary_calc`	One primary calculation type per study based on the following hierarchy: 1) continuous, 2) dichotomous, 3) change from baseline, 4) other reported statistics
`.id`	metapsyTools generated variable: Unique identifier for a trial arm comparison/row.
`.g`	metapsyTools generated variable: Calculated effect size (Hedges' g).
`.g_se`	metapsyTools generated variable: Standard error of Hedges' g.
`.log_rr`	metapsyTools generated variable: Calculated effect size (logeRR).
`.log_rr_se`	metapsyTools generated variable: Standard error of logeRR.
`.event_arm1`	metapsyTools generated variable: Number of events (responders, remission, deterioration cases) in the first trial arm.
`.event_arm2`	metapsyTools generated variable: Number of events (responders, remission, deterioration cases) in the second trial arm.
`.totaln_arm1`	metapsyTools generated variable: Total sample size in the first trial arm.
`.totaln_arm2`	metapsyTools generated variable: Total sample size in the second trial arm.

Study References

Ali, 2003: Ali BS, Rahbar MH, Naeem S, Gul A, Mubeen S, Iqbal A. The effectiveness of counseling on anxiety and depression by minimally trained counselors: a randomized controlled trial. American journal of psychotherapy. 2003;57(3):324-36.
Bathgate, 2021: Bathgate CJ, Kilbourn KM, Murphy NH, Wamboldt FS, Holm KE. Pilot RCT of a telehealth intervention to reduce symptoms of depression and anxiety in adults with cystic fibrosis. Journal of Cystic Fibrosis. 2021.
Calleo, 2015: Calleo JS, Amspoker AB, Sarwar AI, Kunik ME, Jankovic J, Marsh L, et al. A Pilot Study of a Cognitive-Behavioral Treatment for Anxiety and Depression in Patients with Parkinson Disease. Journal of Geriatric Psychiatry and Neurology. 2015;28(3):210-7.
Compen, 2018: Compen F, Bisseling E, Schellekens M, Donders R, Carlson L, van der Lee M, et al. Face-to-face and internet-based mindfulness-based cognitive therapy compared with treatment as usual in reducing psychological distress in patients with cancer: A multicenter randomized controlled trial. Journal of Clinical Oncology. 2018;36(23):2413-21.
Dao, 2011: Dao TK, Youssef NA, Armsworth M, Wear E, Papathopoulos KN, Gopaldas R. Randomized controlled trial of brief cognitive behavioral intervention for depression and anxiety symptoms preoperatively in patients undergoing coronary artery bypass graft surgery. The Journal of thoracic and cardiovascular surgery. 2011;142(3):e109-15.
Den Boer, 2007: den Boer PC, Wiersma D, Ten Vaarwerk I, Span MM, Stant AD, Van den Bosch RJ. Cognitive self-therapy for chronic depression and anxiety: a multi-centre randomized controlled study. Psychological medicine. 2007;37(3):329-39.
Diaz, 2021: Díaz-García A, González-Robles A, García-Palacios A, Fernández-Álvarez J, Castilla D, Bretón JM, et al. Negative and Positive Affect Regulation in a Transdiagnostic Internet-Based Protocol for Emotional Disorders: Randomized Controlled Trial. J Med Internet Res. 2021;23(2):e21335.
Doyle, 2017: Doyle C, Bhar S, Fearn M, Ames D, Osborne D, You E, et al. The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: a randomized controlled trial. British journal of health psychology [Internet]. 2017. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/597/CN-01402597/frame.html
Ezegbe, 2019: Ezegbe BN, Eseadi C, Ede MO, Igbo JN, Anyanwu JI, Ede KR, et al. Impacts of cognitive-behavioral intervention on anxiety and depression among social science education students: A randomized controlled trial. Medicine (Baltimore). 2019;98(15):e14935-e.
Fernandez, 2020: Fernández-Rodríguez C, González-Fernández S, Coto-Lesmes R, Pedrosa I. Behavioral Activation and Acceptance and Commitment Therapy in the Treatment of Anxiety and Depression in Cancer Survivors: A Randomized Clinical Trial. Behavior modification. 2020:145445520916441.
Gonzalez-Robles, 2020: González-Robles, A., Díaz-García, A., García-Palacios, A., Roca, P., Ramos-Quiroga, J. A., & Botella, C. (2020). Effectiveness of a transdiagnostic guided internet-delivered protocol for emotional disorders versus treatment as usual in specialized care: randomized controlled trial. Journal of medical Internet research, 22(7), e18220.
Gunnarson, 2018: Birgitta Gunnarsson A, Wagman P, Hedin K, Hakansson C. Treatment of depression and/or anxiety - outcomes of a randomised controlled trial of the tree theme method(R) versus regular occupational therapy. BMC Psychol. 2018;6(1):25.
Hamilton, 2020: Hamilton J, Saxon D, Best E, Glover V, Walters SJ, Kerr IB. A randomised, controlled pilot study of cognitive analytic therapy (CAT) for stressed pregnant women with underlying anxiety and depression in a routine health service setting. Clinical psychology & psychotherapy. 2020.
Heller, 2020: Heller HM, Hoogendoorn AW, Honig A, Broekman BFP, van Straten A. The Effectiveness of a Guided Internet-Based Tool for the Treatment of Depression and Anxiety in Pregnancy (MamaKits Online): Randomized Controlled Trial. Journal of medical Internet research. 2020;22(3):e15172.
Hynninen, 2010: Hynninen MJ, Bjerke N, Pallesen S, Bakke PS, Nordhus IH. A randomized controlled trial of cognitive behavioral therapy for anxiety and depression in COPD. Respiratory medicine. 2010;104(7):986-94.
Johansson, 2013: Johansson R, Bjorklund M, Hornborg C, Karlsson S, Hesser H, Ljotsson BL, et al. Affect-focused psychodynamic psychotherapy for depression and anxiety through the internet: A randomized controlled trial. PeerJ. 2013;2013(1).
Kladnitski, 2020: Kladnitski N, Smith J, Uppal S, James MA, Allen AR, Andrews G, et al. Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial. Internet Interventions. 2020;20.
Kunik, 2008: Kunik ME, Veazey C, Cully JA, Souchek J, Graham DP, Hopko D, et al. COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial. Psychological medicine. 2008;38(3):385-96.
Lam, 2010: Lam CL, Fong DY, Chin WY, Lee PW, Lam ET, Lo YY. Brief problem-solving treatment in primary care (PST-PC) was not more effective than placebo for elderly patients screened positive of psychological problems. International journal of geriatric psychiatry. 2010;25(10):968-80.
Lerma, 2017: Lerma A, Perez-Grovas H, Bermudez L, Peralta-Pedrero ML, Robles-García R, Lerma C. Brief cognitive behavioural intervention for depression and anxiety symptoms improves quality of life in chronic haemodialysis patients. Psychology and psychotherapy. 2017;90(1):105-23.
Lindegaard, 2020: Lindegaard T, Seaton F, Halaj A, Berg M, Kashoush F, Barchini R, et al. Internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a pilot randomized controlled trial. Cognitive behaviour therapy. 2020:1-20.
Lo, 2013: Lo HH, Ng SM, Chan CL, Lam KF, Lau BH. The Chinese medicine construct "stagnation" in mind-body connection mediates the effects of mindfulness training on depression and anxiety. Complementary therapies in medicine. 2013;21(4):348-57.
Mahmoodi, 2021: 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. Behavioural and Cognitive Psychotherapy. 2021;49(4):454-71.
Mead, 2005: Mead N, MacDonald W, Bower P, Lovell K, Richards D, Roberts C, et al. The clinical effectiveness of guided self-help versus waiting-list control in the management of anxiety and depression: A randomized controlled trial. Psychological Medicine. 2005;35(11):1633-43.
Mullin, 2015: Mullin A, Dear BF, Karin E, Wootton BM, Staples LG, Johnston L, et al. The UniWellbeing course: A randomised controlled trial of a transdiagnostic internet-delivered cognitive behavioural therapy (CBT) programme for university students with symptoms of anxiety and depression. Internet Interventions [Internet]. 2015; 2(2 // (NHMRC) *National Health and Medical Research Council*):[128-36 pp.]. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/428/CN-01069428/frame.html
Muntingh, 2016: Muntingh A. Quality of life and symptoms in patients with chronic depression and anxiety after a self-management training: A randomised controlled trial. [Dutch]. Tijdschrift voor Psychiatrie 58 (7) (pp 504-512), 2016 Date of Publication: July 2016 [Internet]. 2016. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/365/CN-01195365/frame.html.
Newby, 2013: Newby JM, Mackenzie A, Williams AD, McIntyre K, Watts S, Wong N. Internet cognitive behavioural therapy for mixed anxiety and depression: a randomized controlled trial and evidence of effectiveness in primary care [Wellbeing 6]. Psychological Medicine [Internet]. 2013; 43(12):[2635-48 pp.]. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/626/CN-01038626/frame.html
Nissen, 2020: Nissen ER, O'Connor M, Kaldo V, Højris I, Borre M, Zachariae R, et al. Internet-delivered mindfulness-based cognitive therapy for anxiety and depression in cancer survivors: A randomized controlled trial. Psycho-oncology. 2020;29(1):68-75.
Norlund, 2018: Norlund F, Wallin E, Olsson MGE, Wallert J, Burell G, Von Essen L, et al. Internet-based cognitive behavior therapy for symptoms of depression and anxiety among patients with a recent myocardial infarction: the U-CARE Heart randomized trial. European journal of preventive cardiology. 2018;25(2):S63‐S4.
Olason, 2018: Olason M, Andrason RH, Jonsdottir IH, Kristbergsdottir H, Jensen MP. Cognitive Behavioral Therapy for Depression and Anxiety in an Interdisciplinary Rehabilitation Program for Chronic Pain: a Randomized Controlled Trial with a 3-Year Follow-up. Int J Behav Med. 2018;25(1):55-66.
Pachankis, 2020: Pachankis JE, McConocha EM, Clark KA, Wang K, Behari K, Fetzner BK, et al. A transdiagnostic minority stress intervention for gender diverse sexual minority women's depression, anxiety, and unhealthy alcohol use: A randomized controlled trial. Journal of consulting and clinical psychology. 2020;88(7):613-30.
Patel, 2003: Patel V, Chisholm D, Rabe-Hesketh S, Dias-Saxena F, Andrew G, Mann A. Efficacy and cost-effectiveness of drug and psychological treatments for common mental disorders in general health care in Goa, India: a randomised, controlled trial. Lancet [Internet]. 2003; 361(9351):[33-9 pp.]. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/624/CN-00412624/frame.html
Ponsford, 2016: Ponsford J, Lee NK, Wong D, McKay A, Haines K, Alway Y, et al. Efficacy of motivational interviewing and cognitive behavioral therapy for anxiety and depression symptoms following traumatic brain injury. Psychological medicine. 2016;46(5):1079-90.
Proudfoot, 2004: Proudfoot J, Ryden C, Everitt B, Shapiro DA, Goldberg D, Mann A, et al. Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. The British journal of psychiatry : the journal of mental science. 2004;185:46-54.
Ren, 2019: Ren W, Qiu H, Yang Y, Zhu X, Zhu C, Mao G, et al. Randomized controlled trial of cognitive behavioural therapy for depressive and anxiety symptoms in Chinese women with breast cancer. Psychiatry Research. 2019;271:52-9.
Richards, 2020: Richards D, Enrique A, Eilert N, Franklin M, Palacios J, Duffy D, et al. A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety. npj Digital Medicine. 2020;3(1).
Scheidt, 2013: Scheidt CE, Waller E, Endorf K, Schmidt S, Kˆnig R, Zeeck A, et al. Is brief psychodynamic psychotherapy in primary fibromyalgia syndrome with concurrent depression an effective treatment? A randomized controlled trial. General hospital psychiatry [Internet]. 2013; 35(2):[160-7 pp.]. Available from: http://onlinelibrary.wiley.com/o/cochrane/clcentral/articles/075/CN-00878075/frame.html
Schneider, 2021: Schneider LH. Efficacy of Internet-delivered cognitive behavioural therapy following an acute coronary event: A randomized controlled trial: ProQuest Information & Learning; 2021.
Titov, 2011: Titov, N., Dear, B. F., Schwencke, G., Andrews, G., Johnston, L., Craske, M. G., et al. (2011). Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial. Behaviour Research and Therapy, 49, 441–452.
Torres, 2019: Torres-Platas SG, Escobar S, Belliveau C, Wu J, Sasi N, Fotso J, et al. Mindfulness-Based Cognitive Therapy Intervention for the Treatment of Late-Life Depression and Anxiety Symptoms in Primary Care: A Randomized Controlled Trial. and Psychosomatics. 2019;88(4):254-6.
Trimmer, 2018: Trimmer C, Tyo R, Pikard J, McKenna C, Naeem F. Low-Intensity Cognitive Behavioural Therapy-Based Music Group (CBT-Music) for the Treatment of Symptoms of Anxiety and Depression: A Feasibility Study. Behavioural and cognitive psychotherapy. 2018;46(2):168-81.
Troeung, 2014: Troeung L, Egan SJ, Gasson N. A waitlist-controlled trial of group cognitive behavioural therapy for depression and anxiety in Parkinson's disease. BMC psychiatry. 2014;14(1).
Van Beek, 2013: van Beek MHCT, Voshaar RCO, Beek AM, van Zijderveld GA, Visser S, Speckens AEM, et al. A brief cognitive‐behavioral intervention for treating depression and panic disorder in patients with noncardiac chest pain: A 24‐week randomized controlled trial. Depression and anxiety. 2013;30(7):670-8.
Wuthrich, 2019: Wuthrich VM, Rapee RM. Telephone-Delivered Cognitive Behavioural Therapy for Treating Symptoms of Anxiety and Depression in Parkinson's Disease: A Pilot Trial. Clin Gerontol. 2019 Jul-Sep;42(4):444-453. doi: 10.1080/07317115.2019.1580811.
Yorke, 2016: Yorke J, Adair P, Doyle AM, Dubrow-Marshall L, Fleming S, Holmes L, et al. A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma. Journal of Asthma. 2016:0.

Database Flowchart

Studies in the “depression-anxiety-transdiagnostic” dataset were extracted from the larger “depression psychotherapy” database. The study flow of this database can be found below. Next to the searches in the bibliographic databases, we also checked the references of earlier meta-analyses on the topic to identify additional studies.

Companion papers: n=818
Depression is not an inclusion criterion: n=484
Dissertations: n=21
Effect sizes cannot be estimated: n=92
Maintenenance trial: n=138
No control condition: n=68
No psychotherapy for depression: n=291
No random assignment: n=79
Not available: n=67
Other: n=243
Other language: n=22
Protocol paper: n=335
Stepped care/management program: n=48
Studies with chidlren/adolescents: n=69

Further Information

The full protocol of the METAPSY project ↗
Definitions of types of psychotherapies that are included in the Metapsy depression domain ↗
A paper summarizing main results of the Metapsy depression domain ↗
Published meta-analyses using the database ↗
Published 'individual participant data' meta-analyses, based on the database ↗