SBU:s upplysningstjänst
Publikation nr: ut202209
Publicerad: 20 april 2022
Nedladdad: 6 maj 2025
Unified protocol för behandling av barn och ungdomar med ångestsyndrom

Observera att det är möjligt att ladda ner hela eller delar av en publikation. Denna pdf/utskrift behöver därför inte vara komplett. Hela publikationen och den senaste versionen hittar ni på www.sbu.se/ut202209

Unified protocol för behandling av barn och ungdomar med ångestsyndrom

Publicerad: 20 april 2022

Fråga och sammanfattning

Ångest är vanligt bland barn och ungdomar och förkommer ofta tillsammans med annan problematik som nedstämdhet och depression. Unified protocol är ett terapeutiskt behandlingsupplägg som är framtaget för att behandla de underliggande faktorer som är gemensamma för flera psykiska sjukdomar. Protokollet är utvecklat för att kunna användas både vid samsjuklighet och vid enskilda diagnoser.

Fråga

Vilken sammanställd forskning och vetenskapliga studier finns om effekter av behandling med Unified protocol av barn och ungdomar med ångestsyndrom?

Frågeställare: Enhetschef, Barn- och ungdomspsykiatrin, Region Stockholm

Sammanfattning

SBU:s upplysningstjänst har efter litteratursökning inte identifierat någon relevant systematisk översikt.

Upplysningstjänsten har dock identifierat tre artiklar från primärstudier. Dessa har undersökt Unified protocol för behandling av barn och ungdomar med olika typer av ångestdiagnoser. Primärstudier granskas inte med avseende på risk för bias av Upplysningstjänsten så inga resultat eller slutsatser har redovisats i svaret, men studierna finns kortfattat beskrivna i tabell.

Bakgrund

Ängslan, oro och ångest är vanligt förekommande symtom i befolkningen, mest uttalat hos barn och ungdomar. Om symtomen är så svåra att de leder till funktionsnedsättningar och inskränkningar i det dagliga livet kan ångestsyndrom föreligga. Olika ångestsyndrom definieras utifrån specifika kriterier och diagnoser ställs av läkare och i vissa fall av psykologer. Ångestsyndrom är vanligt förekommande i alla åldrar och uppskattningsvis utvecklar omkring 25 procent av befolkningen dessa besvär någon gång under livet. Ångestsyndrom är även vanligt hos barn och unga och ibland föreligger samtidig annan psykisk eller fysisk sjukdom [1].

Unified protocol är ett psykoterapeutiskt behandlingsupplägg som syftar till att behandla flera olika psykiatriska tillstånd samtidigt. Behandlingsprotokollet är en form av kognitiv beteendeterapi (KBT) som är utvecklat för att behandla bakomliggande faktorer gemensamma för flera olika psykiatriska symtom och därmed göra behandlingen mer effektiv vid till exempel samsjuklighet med flera olika diagnoser. Ett annat syfte är att göra det lättare för behandlande personal då flera tillstånd kan behandlas på samma sätt [2] [3].

Avgränsningar

Upplysningstjänsten har gjort sökningar (se Bilaga 1) i databaserna Medline, Embase, PsycInfo och Psychology and Behavioral Sciences Collection. Vi har även sökt publikationer på webbsidor för Socialstyrelsen, regionala HTA-organisationer och INAHTA.

Upplysningstjänsten har tillsammans med frågeställaren formulerat frågan enligt följande PICO1:

För att vi skulle inkludera en artikel i svaret krävde vi att den var publicerad på engelska eller ett av de skandinaviska språken.

Endast artiklar som genomgått en peer review är inkluderade.

För att inkluderas som en systematisk översikt ska författarna ha presenterat en litteratursökning som matchar frågeställningen och är dokumenterad så att det går att bedöma hur väl sökningen täcker området och risken för att den missar relevant litteratur.

1. PICO är en förkortning för patient/population/problem, intervention/index test, comparison/control (jämförelseintervention) och outcome (utfallsmått).

Bedömning av risk för bias

Primärstudier bedöms inte för risk för bias av SBU:s upplysningstjänst eftersom det ställer krav på sakkunskap inom forskningsområdet. Det är därför möjligt att flera av de relevanta primärstudier som inkluderats i svaret kan ha högre risk för bias än de studier som SBU inkluderar i andra rapporter.

Resultat från sökningen

Upplysningstjänstens litteratursökning genererade efter dubblettkontroll totalt 262 artikelsammanfattningar (abstrakt) för översiktsartiklar och 560 abstrakt för primärstudier. Ett flödesschema för urvalsprocessen visas i Bilaga 2. Två utredare på SBU läste alla artikelsammanfattningar för översiktsartiklar och bedömde att åtta kunde vara relevanta för frågan. Dessa artiklar lästes i fulltext av två utredare och de artiklar som inte var relevanta för frågan exkluderades. En utredare på SBU läste alla artikelsammanfattningar för primärstudier och bedömde att 39 artiklar kunde vara relevanta för frågan. Dessa artiklar lästes i fulltext av en utredare och de artiklar som inte var relevanta för frågan exkluderades. Exkluderade artiklar finns listade i Bilaga 3.

Systematiska översikter

Upplysningstjänsten fann ingen systematisk översikt som var relevant för denna fråga och därför redovisas inga resultat eller slutsatser i Upplysningstjänstens svar.

Primärstudier

SBU:s upplysningstjänst identifierade tre artiklar från primärstudier [4] [5] [6], vilka finns översiktligt beskrivna i Tabell 1. En av dessa studerade ungdomar med ångestsyndrom och jämförde Unified Protocol med ett tillägg av mindfulness med enbart Unified Protocol som behandling [6]. En annan jämförde en version av Unified Protocol anpassad för barn (UP-C) med en annan ångestfokuserad aktiv behandling för barn med ångest- eller depressionsdiagnoser [5]. Den tredje studien undersökte en version av Unified Protocol anpassad för ungdomar (UP-A) och jämförde utfall för ångest och depression hos ungdomar med ångestsyndrom som fått denna behandling jämfört med ungdomar på en väntelista, som inte fått behandlingen än [4]. För dessa studier har inte risken för bias bedömts och av det skälet finns inte resultat eller slutsatser beskrivna i text eller tabell.

Tabell 1. Artiklar från primärstudier/Table 1 Primary studies.
UP-A = Unified Protocol for Adolescents; UP-C = Unified Protocol for Children; RCT = Randomised controlled trial
PublicationStudy typePopulationTreatment
Maleki et al
2020
[6]		 Quasi-experimental study Adolescents (mean age 13 yrs) with emotional disorders (n=31) Unified protocol + mindfulness
Kennedy et al
2019
[5]		 RCT Children, 7–13 years, principal diagnosis of an anxiety and/or depressive disorder (n=47) UP-C
Ehrenreich-May et al
2017
[4]		 RCT Adolescents, 12–17 years, primary diagnosis of an anxiety and/or depressive disorder (n=51) UP-A

För att besvara Upplysningstjänstens fråga behövs en systematisk översikt som identifierar alla relevanta primärstudier och som sammanväger resultaten.

Projektgrupp

Detta svar är sammanställt av Idha Kurtdsdotter (utredare), Sally Saad (utredare), Sara Fundell (projektadministratör), Laura Lintamo (produktsamordnare), Per Lytsy (intern sakkunnig) samt Irene Edebert (tillförordnad avdelningschef) vid SBU.

Referenser

  1. Socialstyrelsen. Nationella riktlinjer för vård vid depression och ångestsyndrom. Stockholm: Socialstyrelsen; 2021. Nationella riktlinjer. [accessed Dec 17 2021]. Available from: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/nationella-riktlinjer/2021-4-7339.pdf.
  2. Carlucci L, Saggino A, Balsamo M. On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2021;87:101999. Available from: https://doi.org/10.1016/j.cpr.2021.101999.
  3. 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;27(10):882-90. Available from: https://doi.org/10.1002/da.20735.
  4. Ehrenreich-May J, Rosenfield D, Queen AH, Kennedy SM, Remmes CS, Barlow DH. An initial waitlist-controlled trial of the unified protocol for the treatment of emotional disorders in adolescents. J Anxiety Disord. 2017;46:46-55. Available from: https://doi.org/10.1016/j.janxdis.2016.10.006.
  5. Kennedy SM, Bilek EL, Ehrenreich-May J. A Randomized Controlled Pilot Trial of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children. Behav Modif. 2019;43(3):330-60. Available from: https://doi.org/10.1177/0145445517753940.
  6. Maleki M, Khorramnia S, Foroughi A, Amiri S, Amiri S. Comparing the effectiveness of the unified protocol in combination with an additional mindfulness treatment to the unified protocol alone as treatment for adolescents diagnosed with emotional disorders. Trends Psychiatry Psychother. 2021;43(1):57-64.

 

Bilaga 1 Litteratursökning

PsycINFO/Psychology and Behavioral Sciences Collection via EBSCO 17 December 2021

Title: Unified protocol for the treatment of anxiety in children and adolescents
The final search result, usually found at the end of the documentation, forms the list of abstracts.

AB = Abstract; AU = Author; DE = Term from the thesaurus; MH = Exact Subject Heading from CINAHL Subject Headings; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; " " = Citation Marks; searches for an exact phrase; N = Near Operator (N) finds the words if they are a maximum of x words apart from one another, regardless of the order in which they appear.; W = Within Operator (W) finds the words if they are within x words of one another, in the order in which you entered them
Search termsItems found
Population: Children and adolescents with anxiety
1. DE "Anxiety Disorders" OR DE "Generalized Anxiety Disorder" OR DE "Obsessive Compulsive Disorder" OR DE "Panic Attack" OR DE "Panic Disorder" OR DE "PANIC disorders" OR DE "Phobias" OR DE "Separation Anxiety Disorder" OR TI (Anxiet* OR Obsessive Compulsive Disorder* OR "OCD" OR "GAD" OR Panic Attack* OR Panic Disorder* OR Neurotic Disorder* OR Phobi*) OR AB (Anxiet* OR Obsessive Compulsive Disorder* OR "OCD" OR "GAD" OR Panic Attack* OR Panic Disorder* OR Neurotic Disorder* OR Phobi*) OR SU (Anxiet* OR Obsessive Compulsive Disorder* OR "OCD" OR "GAD" OR Panic Attack* OR Panic Disorder* OR Neurotic Disorder* OR Phobi*) 314,244
2. DE "CHILDREN" OR DE "CHILD patients" OR DE "SCHOOL children" OR ZG "adolescence (13-17 yrs)" OR ZG "school age (6-12 yrs)" OR TI (Child* OR kids OR girl OR girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p#ediatric* OR youngster* OR school* OR ((first or second or third or fourth or fifth or sixth or seventh) N2 grader*) OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*) OR AB (Child* OR kids OR girl OR girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p#ediatric* OR youngster* OR school* OR ((first or second or third or fourth or fifth or sixth or seventh) N2 grader*) OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*) OR SU (Child* OR kids OR girl OR girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p#ediatric* OR youngster* OR school* OR ((first or second or third or fourth or fifth or sixth or seventh) N2 grader*) OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*) 1,848,600
3. S1 AND S2 105,862
Intervention: Unified protocol
4 DE "Transdiagnostic Treatment" OR TX ("UP-C" OR (emotion* N3 detective*) OR "UP-Y") OR TI Transdiagnostic* OR AB Transdiagnostic* OR SU Transdiagnostic* 4,546
5. TX "unified protocol" 423
Study types: systematic reviews
6. DE "Meta Analysis" OR ZC "systematic review" OR ZC "meta analysis" OR DE "Systematic Review" OR TX (systematic* N3 review*) OR TX (metaanaly* OR meta-analy* OR meta analy*) 224,602
Study types: randomised controlled trials and other trials
7. ZC "treatment outcome/clinical trial" OR DE "Clinical Trials" OR DE "Placebo" OR TI (((singl* OR doubl* OR tripl* OR trebl*)) N2 (blind* OR dumm* OR mask*)) OR ((randomi?ed OR controlled) N2 (study OR trial* OR design OR method* OR test* OR assessment OR experiment OR comparison)) OR ((random*) N3 (assign* OR alloca*)) OR (clinical W2 trial*) OR placebo* OR “wait* list*” OR “comparison group*” OR (control* W1 (group* or condition*)) OR (control* W1 (group* or condition*)) OR ((treatment* OR service* OR care) N2 (usual OR standard OR traditional OR ordinary)) OR (randomi?ed N6 n=) OR (compared N2 control*)) OR AB (((singl* OR doubl* OR tripl* OR trebl*)) N2 (blind* OR dumm* OR mask*)) OR ((randomi?ed OR controlled) N2 (study OR trial* OR design OR method* OR test* OR assessment OR experiment OR comparison)) OR ((random*) N3 (assign* OR alloca*)) OR (clinical W2 trial*) OR placebo* OR “wait* list*” OR “comparison group*” OR (control* W1 (group* or condition*)) OR (control* W1 (group* or condition*)) OR ((treatment* OR service* OR care) N2 (usual OR standard OR traditional OR ordinary)) OR (randomi?ed N6 n=) OR (compared N2 control*)) OR SU (((singl* OR doubl* OR tripl* OR trebl*)) N2 (blind* OR dumm* OR mask*)) OR ((randomi?ed OR controlled) N2 (study OR trial* OR design OR method* OR test* OR assessment OR experiment OR comparison)) OR ((random*) N3 (assign* OR alloca*)) OR (clinical W2 trial*) OR placebo* OR “wait* list*” OR “comparison group*” OR (control* W1 (group* or condition*)) OR (control* W1 (group* or condition*)) OR ((treatment* OR service* OR care) N2 (usual OR standard OR traditional OR ordinary)) OR (randomi?ed N6 n=) OR (compared N2 control*)) 426,078
Combined sets:
8. S3 AND S4 639
9. S8 OR S5 1,015
10. S9 AND S6 235
11. S9 AND S7 248
Final result
  10 [Systematic reviews]  
  11 [controlled trials] 248

Cochrane Library via Wiley 17 December 2021 (CDSR, Cochrane Protocols & CENTRAL)

Title: Unified protocol for the treatment of anxiety in children and adolescents
The final search result, usually found at the end of the documentation, forms the list of abstracts.

:au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; " " = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; Cochrane Protocols = Protocols of systematic reviews registered in Cochrane Library; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”
Search termsItems found
Population: children and adolescents with anxiety
1. MeSH descriptor: [Anxiety Disorders] explode all trees 7,472
2. (Anxiety OR Anxieties OR "Obsessive Compulsive Disorder*" OR OCD OR GAD OR "Panic Attack" OR "Panic Disorder*" OR "Neurotic Disorder*" OR "Phobia*" OR phobic):ti,ab,kw 61,965
3. MeSH descriptor: [Child] explode all trees 59,662
4. MeSH descriptor: [Adolescent] explode all trees 108,631
5. (child* OR kids OR girl OR  girls OR boy OR boys OR teen* OR adolescen* OR youth* OR p?ediatric* OR youngster* OR school* OR highschool* OR secondary school* OR secondary education* OR high school* OR juvenile* OR minor*):ti,ab,kw 314,192
6. ((first or second or third or fourth or fifth or sixth or seventh) W grader*):ti,ab,kw 2
7. #3 OR #4 OR #5 OR #6 314193
8. #1 OR #2 62,206
9. #7 AND #8 16,467
Intervention: Unified protocol
10. ("Unified protocol") 167
11. ("UP-C" OR "UP-Y" OR "emotion* detective*" OR transdiagnostic*):ti,ab,kw 912
Combined sets
12. #9 AND #11 203
13. #12 OR #10 338
Final result
  #13 CDSR/1
Cochrane Protocols/1
CENTRAL/336

Embase via Elsevier 17 December 2021

Title: Unified protocol for the treatment of anxiety in children and adolescents
The final search result, usually found at the end of the documentation, forms the list of abstracts.

/de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ' ' = Citation Marks; searches for an exact phrase; NEAR/n = Requests terms that are within 'n' words of each other in either direction; NEXT/n = Requests terms that are within 'n' words of each other in the order specified
Search termsItems found
Population: Children and adolescents with anxiety
1. 'anxiety disorder'/exp OR "Anxiety":ti,ab,kw OR "Anxieties":ti,ab,kw OR "Obsessive Compulsive Disorder":ti,ab,kw OR "Obsessive Compulsive Disorders":ti,ab,kw OR "OCD":ti,ab,kw OR "GAD":ti,ab,kw OR "Panic Attack":ti,ab,kw OR "Panic Disorder":ti,ab,kw OR "Neurotic Disorders":ti,ab,kw OR "Panic Disorders":ti,ab,kw OR "Neurotic Disorder":ti,ab,kw OR "Phobia":ti,ab,kw OR "phobias":ti,ab,kw OR "phobic":ti,ab,kw 516,165
2. 'child'/exp OR 'adolescent'/exp OR child*:ti,ab,kw OR 'kids':ti,ab,kw OR girl:ti,ab,kw OR girls:ti,ab,kw OR boy:ti,ab,kw OR boys:ti,ab,kw OR teen*:ti,ab,kw OR adolescen*:ti,ab,kw OR youth*:ti,ab,kw OR pediatric*:ti,ab,kw OR paediatric*:ti,ab,kw OR youngster*:ti,ab,kw OR school*:ti,ab,kw OR 'first grader*':ti,ab,kw OR 'second grader*':ti,ab,kw OR 'third grader*':ti,ab,kw OR 'fourth grader*':ti,ab,kw OR 'fifth grader*':ti,ab,kw OR 'sixth grader*':ti,ab,kw OR 'seventh grader*':ti,ab,kw OR highschool*:ti,ab,kw OR ((secondary:ti,ab,kw OR high*:ti,ab,kw) AND adj2:ti,ab,kw AND (school*:ti,ab,kw OR education:ti,ab,kw)) OR juvenile*:ti,ab,kw OR minor*:ti,ab,kw 5,225,380
3. 1 AND 2 131,769
Intervention: Unified protocol
4. 'up-c':ti,ab,kw OR 'emotion* detective*':ti,ab,kw OR 'up-y':ti,ab,kw OR 'transdiagnostic':ti,ab,kw OR 'transdiagnostical':ti,ab,kw OR 'transdiagnostic approach'/exp  
5. 'unified protocol'/exp OR 'unified protocol'  
Study types: randomised controlled trials and other controlled trials
6. 'controlled clinical trial'/exp 863,978
7. ((‘singl*’ OR ‘doubl*’ OR ‘tripl*’ OR ‘trebl*’) NEXT/3 (‘blind*’ OR ‘dumm*’ OR ‘mask*’)):ti,ab,kw 262,218
8. ('controlled' NEXT/2 (trial OR comparison OR experiment OR study OR test)):ti,ab,kw 320,958
9. (clinical NEAR/3 trial):ti,ab,kw 267,056
10. ('control*' NEXT/1 (group* OR condition*)):ti,ab,kw 773,552
11. 'comparison group*':ti,ab,kw 25,991
12. 'wait* list*':ti,ab,kw 24,190
13. ((treatment OR intervention OR experimental) NEXT/1 group*):ti,ab,kw 286,289
14. (matched NEXT/1 (control* OR group* OR comparison*)):ti,ab,kw 130,959
15. ((treatment* OR service* OR care) NEAR/2 (usual OR standard OR traditional OR ordinary)):ti,ab,kw 217,862
16. (compared NEAR/3 control*):ti,ab,kw 607,279
17. #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 2,609,887
Study types: systematic reviews
18. 'systematic review'/de OR 'meta analysis'/exp OR 'cochrane database syst rev':ta OR ((systematic NEAR/3 review):ti,ab) OR 'meta analys*':ti,ab OR metaanalys*:ti,ab 548,508
Combined sets
19. #3 AND #4 629
20. #19 OR #5 995
21. #20 AND #18 [systematic reviews] 62
22. #20 AND #17 [controlled trials] 201
Final result
  #21[systematic reviews] 62
  #22 [controlled trials] 201

Medline via OvidSP 17 December 2021

Title: Unified protocol for the treatment of anxiety in children and adolescents
The final search result, usually found at the end of the documentation, forms the list of abstracts.

.ab. = Abstract; .ab,ti. = Abstract or title; .af. = All fields; Exp = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; .sh. = Term from the Medline controlled vocabulary; .ti. = Title; / = Term from the Medline controlled vocabulary, but does not include terms found below this term in the MeSH hierarchy; * = Focus (if found in front of a MeSH-term); * or $ = Truncation (if found at the end of a free text term); .mp = Text, heading word, subject area node, title; " " = Citation Marks; searches for an exact phrase; ADJn = Positional operator that lets you retrieve records that contain your terms (in any order) within a specified number (n) of words of each other
Search termsItems found
Population: Children and adolescents with anxiety
1. exp Child/ or exp adolescent/ 3,199,838
2. (child* or kids or girl or girls or boy or boys or teen* or adolescen* or youth* or p?ediatric* or youngster* or school* or highschool* or secondary school* or secondary education* or high school* or juvenile* or minor*).tw,kw. 2,503,177
3. ((first or second or third or fourth or fifth or sixth or seventh) adj grader*).tw,kw 2,744
4. exp Anxiety Disorders/ 84,490
5. (Obsessive Compulsive Disorder* or OCD or GAD or Panic Attack or Panic Disorder* or Neurotic Disorder* or phobi*).kw,tw. 46,354
6. 1 or 2 or 3 [population age] 4,245,693
7. 4 or 5 [population diagnosis] 104,919
8. 6 and 7 [population] 33,045
Intervention: Unified protocol
9. (Unified protocol or UP-C or UP-Y or emotion* detective*).mp. 450
10. transdiagnostic*.tw,kw. 3,002
11. 9 or 10 3,328
Study types: randomised controlled trials and other controlled trials
12. exp Controlled Clinical Trial/ or random allocation/ 727,611
13. ((singl* or doubl* or tripl* or trebl*) adj3 (blind* or dumm* or mask*)).tw,kw. 186,415
14. (clinical adj3 trial).tw,kw. 169,406
15. clinical trial.pt. 532,426
16. random*.tw,kw. 1,272,900
17. (control* adj (group* or condition*)).tw,kw. 542,714
18. comparison group*.tw,kw. 20,151
19. wait* list*.tw,kw. 14,953
20. ((treatment or intervention or experimental) adj group*).tw,kw. 200,587
21. (matched adj (control* or group* or comparison*)).tw,kw. 95,073
22. ((treatment* or service* or care) adj2 (usual or standard or traditional or ordinary)).tw,kw. 131,615
23. (compared adj3 control*).tw,kw. 412,036
24. 12 or 13 or 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 or 23 2,670,881
Study types: Systematic reviews
25. (Systematic Review or Meta-Analysis).pt. or Cochrane Database Syst Rev.ja. or ((systematic adj3 review) or "meta analys*" or metaanalys*).ti,ab 372,242
Combined sets
26. 8 and 11 [population and intervention] 274
27. 26 and 24 [controlled trials] 85
28. 26 and 25 [systematic reviews] 26
Final result
  27 [controlled trials] 85
  28 [systematic reviews] 26

Bilaga 2 Flödesschema över urval av studier

Flödesschema för systematiska översikter. Från start granskades abstrakt från databassökning (262 översikter och 560 primärstudier). inkluderade inga systematiska översikter men 3 primärstudier

Bilaga 3 Artiklar som exkluderats efter fulltextläsning

Exkluderade artiklarOrsak till exklusion
Systematiska översikter
Carlucci L, Saggino A, Balsamo M. On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2021;87:101999. Available from: https://doi.org/10.1016/j.cpr.2021.101999. Ingen särredovisning av barn och ungdomar
Ebert DD, Zarski AC, Christensen H, Stikkelbroek Y, Cuijpers P, Berking M, et al. Internet and computer-based cognitive behavioral therapy for anxiety and depression in youth: a meta-analysis of randomized controlled outcome trials. PLoS One. 2015;10(3):e0119895. Available from: https://doi.org/10.1371/journal.pone.0119895. Fel intervention
Ewing DL, Monsen JJ, Thompson EJ, Cartwright-Hatton S, Field A. A Meta-Analysis of Transdiagnostic Cognitive Behavioural Therapy in the Treatment of Child and Young Person Anxiety Disorders. Behav Cogn Psychother. 2015;43(5):562-77. Available from: https://doi.org/10.1017/S1352465813001094. Fel intervention
García-Escalera J, Chorot P, Valiente RM, Reales JM, Sandín B. Efficacy of transdiagnostic cognitive-behavioral therapy for anxiety and depression in adults, children and adolescents: A meta-analysis. Revista de Psicopatología y Psicología Clínica. 2016;21(3):147-75. Flera typer av transdiagnostiska protokoll analyseras tillsammans. Ingen särredovisning av Unified protocol.
Pasarelu CR, Andersson G, Bergman Nordgren L, Dobrean A. Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials. Cogn Behav Ther. 2017;46(1):1-28. Available from: https://doi.org/10.1080/16506073.2016.123121. Fel population
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. Available from: https://doi.org/10.1080/16506073.2014.897367. Fel population
Sakiris NBD. A systematic review and meta-analysis of the Unified Protocol as a transdiagnostic emotion regulation based intervention. Clinical Psychology Review. 2019;72(101751). Fel population
Schafer JO, Naumann E, Holmes EA, Tuschen-Caffier B, Samson AC. Emotion Regulation Strategies in Depressive and Anxiety Symptoms in Youth: A Meta-Analytic Review. J Youth Adolesc. 2017;46(2):261-76. Available from: https://doi.org/10.1007/s10964-016-0585-0. Fel intervention
Primärstudier
Ahmadi R, Ahmadizadeh R, Hasani M, Saed O. Transdiagnostic versus construct-specific cognitive behavioural therapy for emotional disorders in patients with high anxiety sensitivity: A double-blind randomised clinical trial. Behav Change. 2021. Fel population
Arendt K, Thastum M, Hougaard E. Efficacy of a Danish version of the Cool Kids program: a randomized wait-list controlled trial. Acta Psychiatr Scand. 2016;133(2):109-21. Available from: https://doi.org/10.1111/acps.12448. Fel intervention
Chu BC, Crocco ST, Esseling P, Areizaga MJ, Lindner AM, Skriner LC. Transdiagnostic group behavioral activation and exposure therapy for youth anxiety and depression: Initial randomized controlled trial. Behav Res Ther. 2016;76:65-75. Available from: https://doi.org/10.1016/j.brat.2015.11.005. Fel intervention
Corpas J, Moriana JA, Vencesla JF, Galvez-Lara M. Effectiveness of brief group transdiagnostic therapy for emotional disorders in primary care: A randomized controlled trial identifying predictors of outcome. Psychother Res. 2021:1-14. Available from: https://doi.org/10.1080/10503307.2021.1952331. Fel population
de la Torre-Luque A, Fiol-Veny A, Essau CA, Balle M, Bornas X. Effects of a transdiagnostic cognitive behaviour therapy-based programme on the natural course of anxiety symptoms in adolescence. J Affect Disord. 2020;264:474-82. Available from: https://doi.org/10.1016/j.jad.2019.11.078. Fel intervention
de Ornelas Maia AC, Nardi AE, Cardoso A. The utilization of unified protocols in behavioral cognitive therapy in transdiagnostic group subjects: A clinical trial. J Affect Disord. 2015;172:179-83. Available from: https://doi.org/10.1016/j.jad.2014.09.023. Fel population
Dear BF, Staples LG, Terides MD, Karin E, Zou J, Johnston L, et al. Transdiagnostic versus disorder-specific and clinician-guided versus self-guided internet-delivered treatment for generalized anxiety disorder and comorbid disorders: A randomized controlled trial. J Anxiety Disord. 2015;36:63-77. Available from: https://doi.org/10.1016/j.janxdis.2015.09.003. Fel population
Diaz-Garcia A, Gonzalez-Robles A, Garcia-Palacios A, Fernandez-Alvarez J, Castilla D, Breton 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. Available from: https://doi.org/10.2196/21335. Fel population
Fernández-Martínez I, Morales A, ra, Espada JP, Essau CA, et al. Effectiveness of the program Super Skills For Life in reducing symptoms of anxiety and depression in young Spanish children. Psicothema. 2019;31(3):298-304. Fel intervention
Gallagher MW, Long LJ, Richardson A, D'Souza J, Boswell JF, Farchione TJ, et al. Examining Hope as a Transdiagnostic Mechanism of Change Across Anxiety Disorders and CBT Treatment Protocols. Behav Ther. 2020;51(1):190-202. Fel population
Gallagher MW, Sauer-Zavala SE, Boswell JF, Carl JR, Bullis J, Farchione TJ, et al. The Impact of the Unified Protocol for Emotional Disorders on Quality of Life. Int J Cogn Ther. 2013;6(1):57-72. Available from: https://doi.org/10.1521/ijct.2013.6.1.57. Fel population
Garcia-Escalera J, Valiente RM, in B, Ehrenreich-May J, Prieto A, Chorot P. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) Adapted as a School-Based Anxiety and Depression Prevention Program: An Initial Cluster Randomized Wait-List-Controlled Trial. Behav Ther. 2020;51(3):461-73. Fel population
Gonzalez-Robles A, Diaz-Garcia A, Garcia-Palacios A, Roca P, Ramos-Quiroga JA, Botella C. Effectiveness of a Transdiagnostic Guided Internet-Delivered Protocol for Emotional Disorders Versus Treatment as Usual in Specialized Care: Randomized Controlled Trial J Med Internet Res. 2020;22(7):e18220. Fel population
Gonzalez-Robles A, Garcia-Palacios A, Banos R, Quero S, Botella C. Upregulating Positive Affectivity in the Transdiagnostic Treatment of Emotional Disorders: A Randomized Pilot Study. Behav Modif. 2019;43(1):26-55. Available from: https://doi.org/10.1177/0145445517735631. Fel population
Gros DF, Merrifield C, Hewitt J, Elcock A, Rowa K, McCabe R, et al. Preliminary Findings for Group Transdiagnostic Behavior Therapy for Affective Disorders Among Youths. Am J Psychother. 2021;74(1):36-9. Fel intervention
Johnston L, Titov N, Andrews G, Dear BF, Spence J. Comorbidity and internet-delivered transdiagnostic cognitive behavioural therapy for anxiety disorders. Cogn Behav Ther. 2013;42(3):180-92. Available from: https://doi.org/10.1080/16506073.2012.753108. Fel population
Johnstone KM, Middleton T, Kemps E, Chen J. A pilot investigation of universal school-based prevention programs for anxiety and depression symptomology in children: A randomized controlled trial. J Clin Psychol. 2020;76(7):1193-216. Available from: https://doi.org/10.1002/jclp.22926. Fel intervention
Khakpoor S, Baytamar JM, Saed O. Investigating the mediational role of intolerance of uncertainty and its components in reducing symptoms of emotional disorders: A double-blind randomized clinical trial. Archives of Psychiatry and Psychotherapy. 2020;22(2):72-80. Fel population
Khakpoor S, Bytamar JM, Saed O. Reductions in transdiagnostic factors as the potential mechanisms of change in treatment outcomes in the Unified Protocol: A randomized clinical trial. Res Psychother. 2019;22(3):402-12. Fel population
Khakpoor S, Saed O, Armani Kian A. Emotion regulation as the mediator of reductions in anxiety and depression in the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders: Double-blind randomized clinical trial. Trends Psychiatry Psychother. 2019;41(3):227-36. Fel population
Kishida K, Ishikawa S-i, Ubara A, Abe N, Arai H. Transdiagnostic behavioural intervention for children with anxiety and depressive disorders: A feasibility study. Behav Change. 2021. Fel intervention
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. Behav Cogn Psychother. 49(4):454-71. Fel population
Mohammadi A, Soleimani M, Mohammadi MR, Abasi I, Foroughi AA. Unified Protocol for Transdiagnostic Prevention of Depression and Anxiety in Iranian Adolescents: Protocol Development and Initial Outcome Data. Iran J Psychiatry. 2019;14(2):171-8. Fel intervention
Nasiri F, Mashhadi A, Bigdeli I, Chamanabad AG, Ellard KK. Augmenting the unified protocol for transdiagnostic treatment of emotional disorders with transcranial direct current stimulation in individuals with generalized anxiety disorder and comorbid depression: A randomized controlled trial. J Affect Disord. 2020;262:405-13. Available from: https://doi.org/10.1016/j.jad.2019.11.064. Fel population
Newby JM, Mewton L, Andrews G. Transdiagnostic versus disorder-specific internet-delivered cognitive behaviour therapy for anxiety and depression in primary care. J Anxiety Disord. 2017;46:25-34. Available from: https://doi.org/10.1016/j.janxdis.2016.06.002. Fel population
Norton PJ, Barrera TL. Transdiagnostic versus diagnosis-specific cbt for anxiety disorders: a preliminary randomized controlled noninferiority trial. Depress Anxiety. 2012;29(10):874-82. Available from: https://doi.org/10.1002/da.21974. Fel population
Norton PJ. A randomized clinical trial of transdiagnostic cognitve-behavioral treatments for anxiety disorder by comparison to relaxation training. Behav Ther. 2012;43(3):506-17. Available from: https://doi.org/10.1016/j.beth.2010.08.011. Fel population
Osma J, Peris-Baquero O, Suso-Ribera C, Farchione TJ, Barlow DH. Effectiveness of the Unified Protocol for transdiagnostic treatment of emotional disorders in group format in Spain: Results from a randomized controlled trial with 6-months follow-up. Psychother Res. 2021:1-14. Available from: https://doi.org/10.1080/10503307.2021.1939190. Fel population
Sauer-Zavala S, Boswell JF, Bentley KH, Thompson H, s J, Farchione TJ, et al. Expectancies, working alliance, and outcome in transdiagnostic and single diagnosis treatment for anxiety disorders: An investigation of mediation. Cognit Ther Res. 2018;42(2):135-45. Available from: https://doi.org/10.1007/s10608-017-9855-8. Fel population
Sharma P, Mehta M, Sagar R. Efficacy of transdiagnostic cognitive-behavioral group therapy for anxiety disorders and headache in adolescents. J Anxiety Disord. 2017;46:78-84. Available from: https://doi.org/10.1016/j.janxdis.2016.11.001. Fel intervention
Shaw AM, Halliday ER, Ehrenreich-May J. The effect of transdiagnostic emotion-focused treatment on obsessive-compulsive symptoms in children and adolescents. J Obsessive Compuls Relat Disord. 2020;26. Fel studiedesign – kontrollgrupp saknas
Tirpak JW, Cassiello-Robbins C, Ametaj A, Olesnycky OS, Sauer-Zavala S, Farchione TJ, et al. Changes in positive affect in cognitive-behavioral treatment of anxiety disorders. Gen Hosp Psychiatry. 2019;61:111-5. Fel population
Titov N, Dear BF, Schwencke G, Andrews G, Johnston L, Craske MG, et al. Transdiagnostic internet treatment for anxiety and depression: a randomised controlled trial. Behav Res Ther. 2011;49(8):441-52. Available from: https://doi.org/10.1016/j.brat.2011.03.007. Fel intervention
Titov N, Dear BF, Staples LG, Terides MD, Karin E, Sheehan J, et al. Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial. J Anxiety Disord. 2015;35:88-102. Available from: https://doi.org/10.1016/j.janxdis.2015.08.002. Fel intervention
Woods BK, Sauer-Zavala S, Farchione TJ, Barlow DH. Isolating the Effects of Mindfulness Training Across Anxiety Disorder Diagnoses in the Unified Protocol. Behav Ther. 2020;51(6):972-83. Available from: https://doi.org/10.1016/j.beth.2020.01.001. Fel population
Zarghami F, Heydarinasab L, Shairi MR, Shahrivar Z. The effectiveness of cognitive behavior treatment based on Kendall's Coping Program on anxiety disorders: A transdiagnostic approach. Developmental Psychology: Journal of Iranian Psychologists.12(45):37-50. Fel intervention