Depression is one of the most prevalent psychological disorders and the leading cause of disability worldwide. The development of effective strategies for the prevention and treatment of depression requires valid and reliable instruments capable of accurately assessing this condition. The present study examined the internal structure and measurement invariance of the Patient Health Questionnaire–9 (PHQ-9) in an Argentine population. Several measurement models proposed in the international literature were tested in a large Argentine sample (N = 5,950), comprising three independent subsamples: an online sample (n = 4,803), a clinical sample of individuals seeking psychological assistance (n = 98), and a random telephone sample (n = 1,049). PHQ-9 item responses were analyzed using Confirmatory Factor Analysis (CFA) and Exploratory Structural Equation Modeling (ESEM). In addition, measurement invariance was evaluated across gender, age groups, and administration formats. The unidimensional model demonstrated good fit across most indices. Although two-factor models showed marginal improvements in fit, correlations between latent factors were consistently high (> 0.80). ESEM analyses indicated that these high correlations were not attributable to estimation bias arising from restrictive CFA specifications, further supporting a unidimensional structure. Moreover, the unidimensional model exhibited measurement invariance across gender, age groups, and administration formats. The findings support the use of the PHQ-9 to derive a global measure (e.g., sum score) of depressive symptom severity in the Argentine population, without systematic bias associated with demographic characteristics or mode of data collection. Further studies are warranted to replicate these results and extend validity evidence.

Introduction Transdiagnostic cognitive-behavioral therapy (TD-CBT) has shown efficacy in reducing emotional symptoms and improving quality of life (QoL) in the primary care setting. However, less is known about the potential mediating processes of change, particularly the indirect effects through emotion regulation strategies (ERS). The present study aimed to examine whether cognitive reappraisal, suppression, negative metacognition, rumination, and worry (measured at post-treatment) account for the effect of TD-CBT (vs. treatment-as-usual [TAU]) on QoL domains (physical, psychological, social, and environmental) at 3- and 12-month follow-up. Methods Multivariate mediation analyses were conducted using the PROCESS macro for SPSS, with 10,000 bootstrap resamples. Treatment group assignment (TAU vs. TAU + TD-CBT) was included as the independent variable. Five ERS were included as potential mediators and QoL domains at 3 and 12 months as dependent variables, adjusted for baseline levels of both ERS and QoL variables. Results Negative metacognition and worry accounted for the primary indirect effects on physical and psychological QoL at both 3 and 12 months. Regarding cognitive reappraisal, a limited impact was observed on psychological and environmental QoL. Rumination yielded a modest indirect effect on psychological and social QoL, although the model explained a substantial proportion of its variance. Finally, suppression did not reach significance as a mediator in any model. Overall, the models accounted for 30% to 50% of the variance across QoL domains. Mediation analyses highlighted the specific role of TD-CBT in modifying these psychological mechanisms to improve long-term QoL, a process that does not occur with TAU alone. Conclusion These findings highlight the relevance of ERS—particularly worry and negative metacognition—as key variables associated with long-term improvements in TD-CBT. Clinically, these results suggest that primary care interventions should prioritize reducing maladaptive ERS to achieve sustained gains in QoL.

Difficulties in emotional regulation are a key transdiagnostic challenge in mental health, contributing to the development and maintenance of anxiety and depression. Virtual reality (VR)-based interventions have emerged as promising tools to enhance emotional skills through immersive and interactive environments. This study presents a preliminary evaluation of Assistance for Emotional Regulation (AYRE), an innovative VR intervention that integrates mindfulness, diaphragmatic breathing, and progressive muscle relaxation; three evidence-based techniques combined for the first time in a fully immersive therapeutic setting. A total of 123 adults from the Dominican Republic (mean age = 28.4 years; 62.6 % women) participated in the study. The intervention consisted of a single 1-hour AYRE session, delivered in a controlled laboratory setting at the university. The study followed a pre-post design without a control group, with anxiety and depressive symptoms assessed immediately before and after the intervention. After a single AYRE session, participants reported meaningful reductions in anxiety and depressive symptoms. Regression analyses showed that higher baseline levels of anxiety and depression were the only significant predictors of post-intervention improvement. Participants evaluated AYRE positively, describing the experience as "calming," "intuitive," and "more engaging than traditional techniques." These impressions support AYRE's feasibility and user acceptability in real-world settings. In conclusion, AYRE appears to be a promising and scalable digital tool for supporting emotional regulation. Its integration of validated techniques into a personalized and immersive VR environment suggests potential for complementing traditional mental health interventions and improving access to care in underserved contexts.

BACKGROUND:The course of persistent physical symptoms (PPS) is heterogeneous, yet little is known about distinct symptom trajectories and their baseline predictors across treatment conditions in primary care. This study aimed to identify PPS trajectories and their associated baseline characteristics in patients receiving treatment as usual (TAU) or transdiagnostic group cognitive behavioral therapy (TDG-CBT). METHODS:Latent Class Growth Analysis (LCGA) was used to identify trajectories of PPS (PHQ-15) over 12 months in 497 participants from the PsicAP randomized clinical trial (TAU: n = 242; TDG-CBT: n = 255). Baseline predictors of trajectory membership were examined using multinomial logistic regression. RESULTS:Three trajectories were identified within each treatment group: recovery, moderate chronic, and severe chronic. Recovery (class 1) was more frequent in TDG-CBT (54.9%) than in TAU (28.9%), whereas moderate chronic (class 2) and severe chronic (class 3) were more common in TAU (class 2 = 49.2%, class 3 = 21.9%) than in TDG-CBT (class 2 = 32.6%, class 3 = 12.6%). In TAU, chronic trajectories were associated with being female, having a partner, and higher baseline depressive symptoms. In TDG-CBT, chronic trajectories were associated with not having a partner, lower income, higher depressive and panic symptoms, and antidepressant use. CONCLUSIONS:TDG-CBT nearly doubles the likelihood of recovery and reduces chronic symptom trajectories compared with TAU. Baseline clinical severity and socioeconomic vulnerability may help identify patients at risk of chronic symptom courses and guide more tailored treatment strategies.

ABSTRACT Introduction The high comorbidity between depression and anxiety challenges traditional nosological models. In order to better reflect this overlap, dimensional approaches seek to clarify whether these symptoms reflect a single underlying construct of general distress or a more complex multidimensionality. The aim was to examine the underlying structure of depression and anxiety symptoms, measured by the PHQ‐9 and GAD‐7, by estimating and comparing three factor models: one‐factor, two‐factor correlated, and bifactor. Methods Data from 1704 primary care (PC) patients from the PsicAP clinical trial were analysed. Dimensionality was assessed using hierarchical Exploratory Graph Analysis (EGA), and models were estimated using Exploratory Structural Equation Modelling (ESEM). Model fit was compared using the χ2, CFI, TLI, RMSEA, and SRMR indices. Results The bifactor model offered the most acceptable comparative fit to the data (CFI = 0.956; TLI = 0.928; RMSEA = 0.076; SRMR = 0.028). Bifactor indices revealed a relevant but not dominant general factor (ECV = 0.40), indicating it does not account for sufficient variance to justify an essentially unidimensional interpretation. Furthermore, the specific factors of depression and anxiety emerged as well‐defined constructs (H > 0.75) with modest reliable specific variance (ωHS: 0.22 and 0.27, respectively). Discussion The findings suggest a hierarchical structure where a general factor of distress coexists with specific factors. This suggests the potential utility of considering a multi‐level perspective in clinical assessment, accounting for both shared distress and specific symptom profiles.

Introduction:Anxiety and depression significantly impair quality of life (QoL) in primary care (PC) patients. While transdiagnostic cognitive behavioural therapy (TD-CBT) is effective, the mechanisms underlying its long-term impact on QoL remain unclear. This study examined whether changes in anxiety and depressive symptoms mediate the effect of TD-CBT on QoL at 12-month follow-up. Methods:Data were used from the "Psychology in Primary Care" trial (PsicAP, from its Spanish acronym), which included 1061 PC patients with anxiety and depression, randomised to TD-CBT plus treatment-as-usual (TAU) or TAU alone. Anxiety and depression were assessed at baseline, post-treatment and 6-month follow-up. QoL was measured at baseline and 12-month follow-up. Path analyses using structural equation modelling (SEM) were used to study direct and indirect effects, controlling for baseline scores and gender. Results:TD-CBT significantly reduced anxiety and depression immediately post-treatment compared to TAU. The only significant indirect effect on 12-month QoL across all dimensions operated sequentially through sustained reductions in depressive symptoms. No significant mediation was found via anxiety symptoms. No specific temporal sequence of symptom improvement mediating QoL was identified. Discussion:TD-CBT improves anxiety and depressive symptoms at post-treatment; nevertheless, long-term QoL improvement occurs primarily through sustained reduction in depressive symptoms and through the direct effects of treatment itself. These findings support the implementation of TD-CBT in PC to achieve lasting functional recovery, highlighting the crucial role of addressing and sustaining improvements in depression.

Objective/s: Transdiagnostic cognitive behavioral therapy has proven to be an effective treatment for emotional disorders. However, the cost-effectiveness of group Transdiagnostic cognitive behavioral therapy remains unknown. Given the growing demand for psychological care in primary care in the context of limited resources, an economic evaluation of transdiagnostic group cognitive behavioral therapy (TD-GCBT) would provide valuable data for treatment decision making. AIMS:To conduct an economic evaluation of the PsicAP treatment protocol. METHOD:The PsicAP-Costs was a multicenter, randomized controlled trial of 429 patients with a suspected diagnosis of anxiety, depression, and/or somatoform disorders. Participants were randomized to treatment as usual (TAU [control group] or TD-GCBT plus TAU [experimental group]). Treatment consisted of seven sessions of TD-GCBT delivered over a 12-14 week period. RESULTS:The primary efficacy outcomes were significantly better in the TD-GCBT + TAU group, with small to large effect sizes for the reduction of depression, anxiety, and somatization symptoms. The economic evaluation yielded a mean incremental effectiveness of .06 quality-adjusted life years with a mean incremental cost of 263€. This resulted in an incremental cost-effectiveness ratio of 4,759€ per quality-adjusted life year. CONCLUSIONS:The integration of TD-GCBT into TAU represents a cost-effective therapeutic approach. The incremental cost-effectiveness ratio of 4,759€ per quality-adjusted life years is well below the willingness-to-pay threshold accepted in Spain, which ranges from 20,000€ to 25,000€. At this threshold, the probability that the intervention is cost-effective is high, ranging from 86% to 89%. Therefore, the implementation of TD-GCBT in PC may represent a cost-effective option for improving the quality of care for emotional disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Background: Despite their frequent comorbidity of depression and anxiety, previous studies have focused on their co-occurrence without considering symptomatic heterogeneity across patients. We aimed to identify distinct profiles of anxious-depressive symptoms and associated characteristics. Method: Participants were 1,061 patients from the PsicAP clinical trial. Latent Profile Analysis was used to identify distinct subgroups of patients, and multinomial logistic regression models examined associations person-related characteristics. Results: Five distinct symptomatic profiles were identified: 1) mild symptoms (23.66%); 2) moderate depression and mild anxiety symptoms (16.78%); 3) moderate depression and anxiety symptoms (25.64%); 4) moderate-severe symptoms without suicidal thoughts (24.59%); and 5) moderate-severe symptoms with suicidal thoughts (9.33%). Regression analyses showed that higher scores in somatization, disability, emotional suppression, rumination, and metacognitive beliefs, as well as lower quality of life and social support, were significantly associated with more severe profiles. Conclusions: Considering symptomatic heterogeneity in primary care is important for personalizing treatments based on individual profiles. This approach may optimize healthcare resources by offering tailored care. Antecedentes: A pesar de la frecuente comorbilidad entre la depresi & oacute;n y la ansiedad, los estudios previos se han centrado en su coocurrencia sin considerar la heterogeneidad sintomatol & oacute;gica entre los pacientes. El objetivo de este estudio ha sido identificar diferentes perfiles de s & iacute;ntomas ansioso-depresivos y sus variables asociadas. M & eacute;todo: Participaron 1,061 pacientes del ensayo cl & iacute;nico PsicAP, aplic & aacute;ndose un an & aacute;lisis de perfiles latentes para identificar subgrupos sintomatol & oacute;gicos diferenciados. Se utilizaron modelos de regresi & oacute;n log & iacute;stica multinomial para explorar las variables asociadas. Resultados: Se identificaron cinco perfiles sintomatol & oacute;gicos distintos: 1) s & iacute;ntomas leves (23.66%); 2) s & iacute;ntomas de depresi & oacute;n moderada y ansiedad leve (16.78%); 3) s & iacute;ntomas moderados de depresi & oacute;n y ansiedad (25.64%); 4) s & iacute;ntomas moderado-severos sin ideaci & oacute;n suicida (24.59%); 5) s & iacute;ntomas moderado-severos con ideaci & oacute;n suicida (9.33%). Los an & aacute;lisis de regresi & oacute;n muestran que puntuaciones m & aacute;s altas en somatizaci & oacute;n, discapacidad, supresi & oacute;n emocional, rumiaci & oacute;n y creencias metacognitivas, as & iacute; como una menor calidad de vida y apoyo social, se asocian significativamente con perfiles m & aacute;s graves. Conclusiones: Considerar la heterogeneidad sintom & aacute;tica en atenci & oacute;n primaria es fundamental para personalizar los tratamientos en funci & oacute;n de las caracter & iacute;sticas individuales. Este enfoque puede ayudar a optimizar los recursos sanitarios ofreciendo una atenci & oacute;n m & aacute;s personalizada a las necesidades del paciente.

The Patient Health Questionnaire-9 (PHQ-9) is one of the most widely used instruments worldwide for screening and quantifying the severity of depressive symptoms. Its brevity, public-domain availability, and strong empirical support have facilitated its broad adoption across clinical and research settings. However, despite its extensive international use, evidence regarding its psychometric performance in the Dominican Republic remains limited. The absence of locally validated instruments entails critical challenges, including reduced diagnostic accuracy, suboptimal assessment of symptom severity, and constraints on clinical decision-making and context-sensitive mental health research. Establishing the validity and reliability of the PHQ-9 in this context is therefore essential to support both applied screening efforts and epidemiological investigations. The present study examined the internal structure, reliability, and convergent validity evidence of the PHQ-9 in a Dominican adult sample. A total of 914 adults participated in the study. Dimensionality was evaluated using parallel analysis based on polychoric correlations and exploratory factor analysis with principal axis factoring. Construct validity evidence was further examined through confirmatory factor analysis using the diagonally weighted least squares estimator. Internal consistency was assessed using McDonald’s omega and Cronbach’s alpha coefficients. Convergent validity evidence was estimated through Spearman correlations between PHQ-9 and Generalized Anxiety Disorder-7 (GAD-7) scores. Findings supported a robust unidimensional structure. Although parallel analysis based on polychoric correlations suggested more than one factor, inspection of the eigenvalue structure, principal axis factor loadings, and confirmatory factor analysis supported retention of a one-factor solution. Reliability indices indicated high internal consistency, with both omega and alpha coefficients exceeding .80. PHQ-9 scores showed strong positive associations with GAD-7 scores, providing convergent validity evidence consistent with the well-documented overlap between depressive and anxiety symptomatology. The PHQ-9 demonstrates solid psychometric performance in Dominican adults, supporting its use as a reliable screening measure of depressive symptom severity in both research and applied settings. These findings extend cross-cultural validation evidence to a previously underexamined Caribbean context. Future studies incorporating structured clinical interviews and depression-specific gold-standard measures are warranted to further examine diagnostic validity, measurement invariance, and optimal cut-off scores.

Chronic diseases are highly prevalent and represent an important burden. Comorbidity between chronic diseases and emotional disorders is common, specially for people with comorbid depression and anxiety as they lead to a worsening of the prognosis. Although the Patient Health Questionnaire (PHQ) can provide an easy and inexpensive way to detect them, they often remain undetected. This study explores the prevalence of these conditions amongst hospital employees using a cross-sectional study (n = 1,075). Based on employee health care records, 89 of these people had some type of chronic physical condition. We then randomly selected 89 age-and sex-matched healthy individuals for comparison. All participants completed screening tools for depression (PHQ-9) and anxiety (GAD-7). Depression and anxiety rates were, respectively, 2.97 and 2.59 times higher (OR) in the chronic group, indicating that people with chronic conditions are especially sensitive to psychosocial risks. These findings underscore the need to routinely monitor the emotional health of workers for the early detection of emotional disorders and specially in the case of particularly sensitive workers, such as those with known chronic illnesses.

INTRODUCTION:Anxiety and depressive disorders represent a public health challenge, with high prevalence rates and considerable impact on quality of life (QoL) and functioning. Despite evidence supporting the efficacy of transdiagnostic cognitive behavioural therapy (TD-CBT), its implementation in settings such as primary care (PC) remains limited. The aim of this paper is to analyse the results of the PsicAP-CV, a clinical trial evaluating the effectiveness and implementation of TD-CBT in the PC setting. METHODS:The study included 320 patients from the PsicAP-CV trial, a Stepped Wedge Cluster-Randomised Trial (SW-CRT). Symptoms of anxiety and depression were assessed, as well as QoL and functioning. Linear models were used to study treatment effects on outcomes and rates of recovery, reliable recovery and deterioration were calculated. RESULTS:findings indicate that TD-CBT is more effective than treatment-as-usual (TAU) in reducing symptoms of anxiety and depression, as well as improving QoL and functioning. In addition, although the overall reduction in symptomatology was similar between patients who received immediate treatment (EG1) and those who received delayed treatment (EG2), there was a trend in favour of the EG1 group in the recovery indicators. DISCUSSION:these findings confirm the efficacy of TD-CBT for treating common mental disorders in PC and point to SW-CRT designs as a feasible and ethically sound avenue for implementing and scaling these evidence-based interventions within public health systems. They also support the broader integration of psychologists into PC, thus offering a scalable model that can significantly improve access to and outcomes of mental health care. TRIAL REGISTRATION:EURADICT 2013-001955-11/ISRCTN58437086.

This study examined the psychological impact of the Jet Set nightclub collapse in Santo Domingo, Dominican Republic, on April 8, 2025. Through a comprehensive approach, the research aimed to assess emotional symptoms in the immediate aftermath of the disaster. A prospective cross-sectional design was applied with a purposive sample of 1,034 adults who completed an online survey between April 9 and 15. Standardized instruments were used to evaluate post-traumatic stress disorder (PTSD), depression, anxiety, perceived social support and emotion regulation strategies. The study had three main objectives: (a) to estimate the prevalence of clinically significant emotional symptoms; (b) to analyze symptom variation according to trauma exposure level (direct, intermediate or vicarious); and (c) to explore sociodemographic and psychological predictors through multiple regression models. Results showed prevalence rates of 14.1% for PTSD, 27.9% for depression and 21.7% for anxiety. Higher symptom severity was observed among participants with direct exposure. Emotion suppression was consistently associated with greater psychological distress, while perceived social support was a protective factor against depression and anxiety. Female gender and younger age also emerged as significant predictors. These findings highlight the importance of considering both individual and contextual factors in post-disaster mental health responses and provide regionally relevant evidence to inform culturally sensitive interventions.

INTRODUCTION:Emotional disorders (ED) are highly prevalent worldwide. The PsicAP trial, conducted in Spain, demonstrated the benefits of adding transdiagnostic cognitive behavioural therapy (TD-CBT) to treatment as usual (TAU) for the attention of these disorders in primary care (PC). Here we describe the design of a stepped wedge randomized controlled trial (RCT), inspired by the PsicAP project. This RCT has two main aims: 1) to test the implementation of the PsicAP protocol in a real clinical setting, further evaluating possible mechanisms of change underlying the efficacy of TD-CBT (emotional regulation, alliance, and therapist experience and training), and 2) to assess the impact of psychotropic medication use on neuropsychological function and treatment outcomes. METHODS:A single-blind multicentre RCT with a stepped wedge design will be conducted. Participants (N=320) will be randomly assigned to an experimental group (EG1) or to a waiting list group (WG). The EG1 will receive immediate treatment and the WG will remain on the waiting list for 3 months. After this time, the WG will become a second experimental group (EG2) that will receive the same treatment as EG1 (PsicAP protocol). Patients will be assessed at post-treatment, at 3 and 9 months. Before starting treatment, a random subsample of patients (n=90) will undergo a neuropsychological assessment. These patients will be assigned to three groups based on their use of psychotropic medication at the time of randomization: no psychotropic medication, short-term use (< 3 months) and long-term use (≥ 3 months). All 90 participants will undergo the same neuropsychological assessment at one year. The RCT is expected to run from 01/05/23 to 01/10/25. DISCUSSION:The results of this trial are expected to provide further support for the efficacy of the PsicAP TD-CBT protocol, as well as insight into the mechanisms of change that lead to the positive therapeutic outcomes of this protocol. In addition, this study will help determine the effects of short- and long-term psychotropic use on neuropsychological function and therapeutic outcomes. In short, it is hoped that this RCT will help to better understand how to implement evidence-based psychological treatment in the PC setting. TRIAL REGISTRATION:EURADICT 2013-001955-11/ ISRCTN58437086.

Anxiety and depressive disorders are the most prevalent disorders worldwide and significantly impair quality of life (QoL). Transdiagnostic cognitive behavioural therapy (TD-CBT) is effective in treating these disorders and improving QoL, but its long-term mechanisms of change are poorly understood. Rumination and worry are key processes addressed by TD-CBT. In this study, we analysed the sequential effect of TD-CBT on post-treatment rumination and worry, anxiety/depression symptoms at 6-months and psychological and physical QoL at 12-months. We use data from PsicAP, a randomised clinical trial in the Primary Care (PC) setting, with 1061 participants randomised to TAU (treatment as usual) or TD-CBT+TAU. Path analyses using SEM were employed to test serial mediation models. Analyses indicated that TD-CBT exerts its long-term beneficial effects on QoL through a cascade of effects, whereby first the maladaptive cognitive processes of rumination and worry are reduced (post-treatment), then anxiety and depressive symptoms (6-months) and finally QoL is improved (12-months). This study provides longitudinal evidence on the mechanisms of change of TD-CBT in patients with anxiety and depression. It also highlights the importance of targeting transdiagnostic interventions towards early modification of negative repetitive thought processes as a critical pathway to long-term symptomatic and functional recovery.

Introducción: Ansiedad, tristeza e ira son emociones vinculadas a desórdenes emocionales que afectan la calidad de vida. Sin embargo, barreras como el costo, el estigma y el acceso limitan la búsqueda de tratamiento. Esta investigación evaluó la efectividad de “Bemocional”, una plataforma virtual basada en evidencia, para reducir síntomas emocionales y mejorar el bienestar en dominicanos. Método: Participaron 60 dominicanos que completaron lecturas diarias en “Bemocional” durante 10 días, enfocadas en una emoción específica. Resultados: Se observó una disminución significativa en ansiedad, M = 21 a M = 18 y p < .01; depresión M = 20 a M = 16 y p < .01; e ira-reacción, M = 6.9 a M = 5.9 y p < .01. El bienestar subjetivo también mejoró, M = 10.9 a M = 11.8 y p < .05. Conclusión: “Bemocional” demostró ser una herramienta efectiva para reducir la sintomatología emocional y promover el bienestar en la población dominicana.

Depression and anxiety disorders are the most prevalent mental disorders in the world. The transdiagnostic approach to the study of these emotional disorders suggests that certain diagnostic categories, such as depression or anxiety disorders, share common underlying factors. This paper evaluated several models of common maladaptive cognitive factors in depressive and anxiety disorders (Study 1) and the predictive validity of these models (Study 2). In Study 1, 1703 primary care patients with suspected emotional disorder completed brief scales to assess the following cognitive factors: worry, rumination, attention to threat, and metacognitions. We found that the model with the best fit was the bifactor model, estimated through an exploratory structural equation model (ESEM). This bifactor model suggests that individual cognitive factors can be explained by a general factor plus four independent factors, evidencing the existence of a transdiagnostic cognitive factor (TD-C factor). In Study 2, a subgroup of 178 participants (from Study 1) were clinically diagnosed by semi-structured clinical interviews with major depressive disorder, generalized anxiety disorder, and/or panic disorder. The predictive validity of TD-C factor was acceptable (AUC > 0.80), but specific factors were not predictive (AUC < 0.70), indicating that TD-C factor was a significant predictor for each diagnosis. This study supports the claim that there is a transdiagnostic cognitive factor that can predict the diagnosis of various depressive and anxiety disorders, thus potentially representing a useful transdiagnostic assessment.

Comorbidity is more the rule than the exception in mental health, specifically in the case of anxiety and depression. Transdiagnostic models studied the underlying processes to improve mental health treatment and understating. Objective: This systematic review searchs for evidence on transdiagnostic risk factors for anxiety and depression in the clinical population diagnosed with these psychopathological conditions, by analysing the different types or categories of factors identified. Methods: A systematic review was registered in PROSPERO (registration number CRD42022370327) and was designed according to PRISMA-P guidelines. Two independent reviewers with field knowledge assessed the study quality to reduce bias. Results: Fifty-three articles were examined, and the transdiagnostic variables were grouped into three categories: psychological, biological, and sociocultural. Conclusions: The most studied category was that of psychological variables, especially cognitive processes, negative affect, and neuroticism, intolerance of uncertainty, anxiety sensitivity. Biological and sociocultural factors require more study to support their transdiagnostic approach. La comorbilidad es más la regla que la excepción en salud mental y, sobre todo, en el caso de la ansiedad y la depresión. Los modelos transdiagnósticos estudian los procesos subyacentes para mejorar el tratamiento y la comprensión de la salud mental. Objetivo: Esta revisión sistemática busca evidencias sobre los factores de riesgo transdiagnósticos para la ansiedad y la depresión en la población clínica diagnosticada de estas condiciones psicopatológicas, analizando los diferentes tipos o categorías de factores identificados. Método: Se registró una revisión sistemática en PROSPERO (número de registro CRD42022370327) y se diseñó de acuerdo con las guías PRISMA-P. La calidad del estudio fue evaluada por dos revisores independientes con conocimiento del campo para reducir el posible sesgo. Resultados: Cincuenta y tres artículos fueron examinados y las variables transdiagnósticas fueron agrupadas en tres categorías: psicológicas, biológicas y socioculturales. Conclusiones: La categoría más estudiada fue la de variables psicológicas, en especial los procesos cognitivos, afecto negativo y neuroticismo, intolerancia a la incertidumbre, sensibilidad a la ansiedad. Los factores biológicos y socioculturales requieren más estudio para sustentar su enfoque transdiagnóstico.

Introduction The aim of this study was to use cluster analysis based on the trajectory of five cognitive-emotional processes (worry, rumination, metacognition, cognitive reappraisal and expressive suppression) over time to explore differences in clinical and performance variables in primary care patients with emotional symptoms. Methods We compared the effect of adding transdiagnostic cognitive-behavioural therapy (TD-CBT) to treatment as usual (TAU) according to cluster membership and sought to determine the variables that predicted cluster membership. 732 participants completed scales about cognitive-emotional processes, anxiety and depressive symptoms, functioning, and quality of life (QoL) at baseline, posttreatment, and at 12 months. Longitudinal cluster analysis and logistic regression analyses were carried out. Results A two-cluster solution was chosen as the best fit, named as “less” or “more” improvement in cognitive-emotional processes. Individuals who achieved more improvement in cognitive-emotional processes showed lower emotional symptoms and better QoL and functioning at all three time points. TAU+TD-CBT, income level, QoL and anxiety symptoms were significant predictors of cluster membership. Conclusions These results underscore the value of adding TD-CBT to reduce maladaptive cognitive-emotional regulation strategies. These findings highlight the importance of the processes of change in therapy and demonstrate the relevance of the patient’s cognitive-emotional profile in improving treatment outcomes.

Abstract: This study aimed to evaluate and determine the efficacy of a brief transdiagnostic treatment in group format for people with mild and moderate emotional disorders, and to establish correlations between the changes after treatment in the different variables. This work had a single-group experimental design with pre-post measures. Participants (n =18) were randomly assigned to the PsicAP-Cost project design, from which the experimental group data have been extracted. Participants were assessed pre- and post-intervention with the following measures: PHQ-15, PHQ-9, GAD-7, PSQW-A, RRS-B, and CERQ-18. Brief transdiagnostic therapy was found to be effective in reducing depressive symptoms (p = .001), anxious symptoms (p = .011), and worry (p = .018) with high/moderate effect sizes. In addition, significant positive correlations were found between changes in depressive symptoms and worry variables, and between changes in anxious symptoms and rumination. In conclusion, brief transdiagnostic treatments can be a treatment to consider for patients with mild and moderate emotional disorders in Primary Care due to their efficacy in some symptoms and their characteristics.