ClinicalTrials.gg
CompletedNCT02954731TRACT-RCTUpdated Sep 16, 2020

Trans-diagnostic Group CBT vs. Standard Group CBT for Depression, Social Anxiety and Agoraphobia/Panic Disorder

An interventional study of UP-CBT and Standard-CBT in Depression, Unipolar, Anxiety Disorder Social and Panic Disorder, sponsored by Psychiatric Research Unit, Region Zealand, Denmark. Completed at 4 sites in Denmark. Open to participants aged 18 Years to 64 Years. Per ClinicalTrials.gov, last updated 2020-09-16.

Sponsored by Psychiatric Research Unit, Region Zealand, Denmark · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
292
Allocation
Randomized
Ages
18 Years to 64 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 27 studies in Depressive Disorder with a site in Denmark — 3 open to participants now, 4 under way, none of them phase 3. Depressive Disorder · Denmark.

Enrollment
4th of 23
292 · median 64
Started
2016
with 1 other
No phase
19 of 27
2 open now
Registered
10th of 27
by date
Lead sponsor
2 of 27
Psychiatric Research Unit, Region Zealand, Denmark

Among the 27 studies in Depressive Disorder with a site in Denmark, this one is the 4th largest by enrollment of the 23 interventional ones that give a count, is one of 2 that started in 2016, is one of 19 with no phase, and was the 10th registered.

Depressive Disorder

855 studies on the registry are indexed under Depressive Disorder; 159 are open to participants now.

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Open to participants now

3 of the 27 studies in Depressive Disorder with a site in Denmark are open now. Recruiting first, the newest first:

All 3 open studies →

A study can be open while its sites in Denmark have not opened yet or have stopped. Only those recruiting at a site in Denmark →

Who these studies take

Of the 116 Depressive Disorder studies recruiting now, 44 (38%) set no upper age limit and 66 (57%) stop at 75 or younger; 24 take children under 18; 25 take healthy volunteers.

This study: 18 Years to 64 Years · all sexes · no healthy volunteers.

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02

Study summary

Transdiagnostic Cognitive Behavior Therapy (CBT) delivered in the individual format, have been proven just as effective as traditional diagnosis specific CBT manuals. The investigators have translated and modified the "The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders" (UP-CBT) to make it applicable as group therapy in Danish Mental Health Service and a naturalistic trial of this manual has shown promising results. As the use of one manual instead of several diagnosis specific manuals in regional clinics could simplify logistics and reduce waiting time, the investigators want to compare group UP-CBT with diagnosis specific group CBT.

Method: A partial blinded, pragmatic, non-inferiority, multicentre randomized clinical trial (RCT). UP-CBT is compared to treatment-as-usual CT. 124 patients are included in each intervention arm, recruited from three Danish regional Mental Health Service Clinics. 31st July 2018 suppl: Inclusion number expanded to 170 in each arm due to unexpected large drop-out.

Read the detailed description

Background: Transdiagnostic Cognitive Behavior Therapy (TCBT) Manuals delivered in individual format, have been reported to be just as effective as traditional diagnosis specific CBT manuals. The investigators have translated and modified the "The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders" (UP-CBT) developed by Barlow and colleagues for use in Mental Health Service (MHS), and shown effects comparable to traditional CBT in a naturalistic trial. As the use of one manual instead of several diagnosis-specific manuals could simplify logistics, reduce waiting time, and increase therapist expertise compared to diagnosis specific CBT, the study aim to test the relative efficacy of group UP-CBT and diagnosis specific group CBT.

Methods/design: It is a partially blinded, pragmatic, non-inferiority, parallel, multi-center randomized controlled trial (RCT) of UP-CBT vs diagnosis specific CBT for depression, social anxiety disorder and agoraphobia/panic disorder. In both arms, the intervention consists of weekly group session for 14 weeks. In total, 248 patients are recruited from three regional MHS centers across the country and included in two intervention arms.31st July 2018 suppl: Inclusion number expanded to 340 due to unexpected large drop-out.

Outcomes are measured at end of therapy and at 6 months follow-up. Weekly patient-rated outcomes and group evaluations are collected for every session. Outcome assessors, blind to delivered intervention, will perform the observer-based symptom ratings, and fidelity assessors will monitor manual adherence.

Discussion: The current study will be the first RCT investigating the dissemination of the UP in a MHS setting and UP delivered in groups and including patients with depression. Hence the results are expected to add substantially to the evidence base for rational group psychotherapy in MHS. The planned moderator and mediator analyses could spur new hypotheses about mechanisms of change in psychotherapy and the association between patient characteristics and treatment effect.

03

Conditions studied

  • Depression, Unipolar
  • Anxiety Disorder Social
  • Panic Disorder

Keywords

  • Cognitive Behavior Therapy
  • Negative Affect
  • Unified Protocol
  • Session Tracking
  • Mechanisms of Change in Psychotherapy
04

Who can participate

Ages eligible
18 Years to 64 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Referred to Danish Mental Health Service

  1. a principal diagnosis of Unipolar Depression (single episode or recurrent)(app. 50%), Social Anxiety Disorder (app. 25%), and Agoraphobia/Panic Disorder (app 25%)
  2. the patient is currently not using any antidepressants or use accepted antidepressants (according to predefined list), which have been unchanged for at least 4 weeks before inclusion and no change in antidepressants is anticipated,
  3. sufficient knowledge of the Danish language.

Exclusion criteria

Exclusion Criteria:

  1. risk of suicide is high according to clinicians or assessment researchers
  2. alcohol or drug dependence,
  3. cluster A or B () personality disorder diagnosed by intake clinicians or assessment researcher,
  4. co-morbidity of pervasive developmental disorder, psychotic disorders, eating disorders, bipolar disorder, or severe physical illness,
  5. psychopharmacological treatment other than those predefined as acceptable,
  6. patient does not accept to stop the use of anxiolytics within the first four weeks of intervention.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

DSM diagnostic criteria

The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
292 participants (actual)

Study arms

  • Experimental
    UP-CBT

    The "Unified Protocol for Transdiagnostic Treatment of Emotional Disorders" (UP) is one of the most widely studied transdiagnostic manuals. Here, the investigators apply a group manual that has been modified from the published UP for individual therapy based on recommendations on group delivery from the UP Institute (personal communications) and integrations modifications necessary for the delivery in the Mental Health Service. Group UP-CBT, consist of 8 treatment modules delivered in 14 group sessions given weekly in 2 hour sessions.

    Behavioral: UP-CBT

  • Active comparator
    Standard-CBT

    Group CBT following Danish versions of diagnosis specific manuals (Social Anxiety Disorder (SAD) Group; Depression (DEP) Group; Agoraphobia/Panic Disorder (Ag/PD) (standard-CBT). The original elements of psychoeducation, cognitive restructuring, and exposure/activity scheduling are present in the applied manuals. Standard-CBT, consist of 8 treatment modules delivered in 14 group sessions given weekly in 2 hour sessions.

    Behavioral: Standard-CBT

Interventions

  • BehavioralUP-CBT

    Psychotherapy in groups based on the "Unified Protocol" a third generation CBT-type psychotherapy

  • BehavioralStandard-CBT

    Psychotherapy in groups based on diagnosis specific, manualized, cognitive behavior therapy

06

What researchers measure

Primary outcomes

  1. WHO Well-Being Index (WHO-5)

    Self-rating questionnaire, 5 items on positive quality of life, web-based

    Time frame: Week 19 after allocation

Secondary outcomes

  1. Hopkins Symptom Check List (SCL-25)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  2. Work and Social Adjustment Scale (WSAS)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  3. Hamilton Depression Rating Scale (HDRS)

    6-item HDRS based on telephone interview

    Time frame: Week 19 after allocation

  4. Hamilton Anxiety Rating Scale (HARS)

    6-item HARS based on telephone interview

    Time frame: Week 19 after allocation

Other outcomes

  1. Overall Anxiety Severity and Impairment Scale (OASIS)

    Validated questionnaire

    Time frame: Weekly, weeks 4-19 after allocation, before session

  2. Overall Depression Severity and Impairment Scale (ODSIS)

    Validated questionnaire

    Time frame: Weekly, weeks 4-19 after allocation, before session

  3. WHO Well-Being Index (WHO-5)

    Validated questionnaire

    Time frame: Weekly, weeks 4-19 after allocation, before session

  4. Positive Affect and Negative Affect Schedule (PANAS)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  5. Positive Affect and Negative Affect Schedule (PANAS)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  6. Hopkins Symptom Check List (SCL-25)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  7. Emotion Regulation Questionnaire (ERQ)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  8. Emotion Regulation Questionnaire (ERQ)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  9. WHO Well-Being Index (WHO-5)

    Self-rating questionnaire, 5 items on positive quality of life, web-based

    Time frame: Week 42-43 after allocation

  10. Emotion Regulation Strategies Questionnaire (ERSQ)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  11. Emotion Regulation Strategies Questionnaire (ERSQ)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  12. Perseverative Thinking Questionnaire (PTQ)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  13. Perseverative Thinking Questionnaire (PTQ)

    Validated questionnaires - web-based

    Time frame: Week 42-43 after allocation

  14. Becks Depression inventory (BDI-II)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  15. Becks Depression inventory (BDI-II)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  16. Work and Social Adjustment Scale (WSAS)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  17. Personality Inventory for DSM-5 - Short Form (PID-5 SF) Negative Affectivity and Detachment domain scores

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  18. Personality Inventory for DSM-5 - Short Form (PID-5 SF) Negative Affectivity and Detachment domain scores

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  19. Liebowitch Social Anxiety Scale (LSAS)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  20. Liebowitch Social Anxiety Scale (LSAS)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  21. Panic Disorder Severity Scale (PDSS)

    Validated questionnaire - web-based

    Time frame: Week19 after allocation

  22. Panic Disorder Severity Scale (PDSS)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  23. Mobility Inventory for Agoraphobia (MIA)

    Validated questionnaire - web-based

    Time frame: Week 19 after allocation

  24. Mobility Inventory for Agoraphobia (MIA)

    Validated questionnaire - web-based

    Time frame: Week 42-43 after allocation

  25. Hamilton Depression Rating Scale

    6-item HDRS based on telephone interview

    Time frame: Week 42-43 after allocation

  26. Hamilton Anxiety Rating Scale

    6-item HARS based on telephone interview

    Time frame: Week 42-43 after allocation

  27. Client Satisfaction Questionnaire

    8-item validated questionnaire, web-based

    Time frame: Week 43

  28. Patient Evaluation of Group Therapy

    Purpose-made questionnaire

    Time frame: Week 19

  29. Group Questionnaire - brief

    8 items from validated questionnaire about group atmosphere

    Time frame: Weekly, weeks 4-19 after allocation, after session

  30. Therapist Ratings of session methods and atmosphere

    Purpose-made questionnaire

    Time frame: Weekly, weeks 4-19 after allocation, after session

  31. Homework and Event Tracker

    Purpose-made question for patients about homework and events previous week

    Time frame: Weekly, weeks 4-19 after allocation, before session

07

Study locations

4 sites
  • Psychotherapeutic Unit, Mental Health Centre Copenhagen
    Copenhagen, Capital Region 2200, Denmark
  • Outpatient Clinic for Anxiety and Personality Disorders
    Risskov, Central Region 8240, Denmark
  • Outpatient Clinic for Mania and Depression
    Risskov, Central Region 8240, Denmark
  • Psychiatric Outpatient Clinic
    Slagelse, Region Zealand 4200, Denmark
08

References and documents

Publications

  • Reinholt N, Aharoni R, Winding C, Rosenberg N, Rosenbaum B, Arnfred S. Transdiagnostic group CBT for anxiety disorders: the unified protocol in mental health services. Cogn Behav Ther. 2017 Jan;46(1):29-43. doi: 10.1080/16506073.2016.1227360. Epub 2016 Oct 5. PubMed 27705086 ↗
  • Reinholt N, Krogh J. Efficacy of transdiagnostic cognitive behaviour therapy for anxiety disorders: a systematic review and meta-analysis of published outcome studies. Cogn Behav Ther. 2014;43(3):171-84. doi: 10.1080/16506073.2014.897367. Epub 2014 Mar 19. PubMed 24646219 ↗
  • Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, Gallagher MW, Barlow DH. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther. 2012 Sep;43(3):666-78. doi: 10.1016/j.beth.2012.01.001. Epub 2012 Jan 18. PubMed 22697453 ↗
  • Wilamowska ZA, Thompson-Hollands J, Fairholme CP, Ellard KK, Farchione TJ, Barlow DH. Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depress Anxiety. 2010 Oct;27(10):882-90. doi: 10.1002/da.20735. PubMed 20886609 ↗
  • Arnfred SM, Aharoni R, Hvenegaard M, Poulsen S, Bach B, Arendt M, Rosenberg NK, Reinholt N. Transdiagnostic group CBT vs. standard group CBT for depression, social anxiety disorder and agoraphobia/panic disorder: Study protocol for a pragmatic, multicenter non-inferiority randomized controlled trial. BMC Psychiatry. 2017 Jan 23;17(1):37. doi: 10.1186/s12888-016-1175-0. PubMed 28114915 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No — The datasets generated by the planned study will not be publicly available due to the rules of the Danish Data Protection Agency, but will be available from the corresponding author, after publication, on reasonable request and following signed confidentiality agreement with PI and the Danish Data Protection Agency Region Zealand.

09

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Dec 2016, a primary completion of Apr 2019 and a completion of Dec 2019. It does not say whether these dates are actual or estimated.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 25, 2016
First posted
Nov 3, 2016
Start
Dec 2016
Primary completionActual
Apr 11, 2019
CompletionActual
Dec 11, 2019
Last update
Sep 16, 2020
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 16, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02954731
Lead sponsor
Psychiatric Research Unit, Region Zealand, Denmark
Collaborators
Aarhus University Hospital, Mental Health Services in the Capital Region, Denmark, University of Copenhagen
Responsible party
Sidse Arnfred (Associate Professor, Consultant, Psychiatric Research Unit, Region Zealand, Denmark) — Principal investigator
First posted
Nov 3, 2016
Start date
Dec 2016
Primary completion
Apr 11, 2019
Completion
Dec 11, 2019
Last update
Sep 16, 2020

Study contacts

Sidse MH Arnfred, MD,PhD,DMSc
principal investigator · Universityhospital Copenhagen, Psychiatry West, Mental Health Services Region Zealand

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2020. You cannot join it, but the record below documents what was studied.

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