Descripción del inventario multidimensional para los trastornos emocionales (MEDI) para la evaluación y diagnóstico dimensional

El modelo híbrido dimensional-categorial para el diagnóstico de los trastornos emocionales propone la existencia de un conjunto de dimensiones compartidas asociadas a la etiología y mantenimiento de los diferentes trastornos emocionales (trastornos de ansiedad, del estado de ánimo y otros trastornos relacionados). El Inventario Multidimensional para los Trastornos Emocionales (MEDI) se desarrolló para evaluar de manera eficiente las dimensiones propuestas por este modelo híbrido (neuroticismo, afecto positivo, estado de ánimo deprimido, activación autónoma, ansiedad somática, ansiedad social, intrusiones cognitivas, reexperimentación traumática y evitación) y cuenta con pruebas de validez en España. El objetivo del presente artículo es describir esta herramienta de evaluación dimensional y comparar sus resultados con los obtenidos siguiendo los criterios del DSM-5 en una serie de casos clínicos. Se discuten las virtudes del MEDI y las ventajas de una perspectiva dimensional transdiagnóstica en la personalización del tratamiento psicológico

What format of treatment do patients with emotional disorders prefer and why? Implications for public mental health settings and policies

Objective We analyzed the preference of three psychological intervention formats—individual, group, and online—in a sample of 267 patients with a primary diagnosis of emotional disorder in Spanish public mental health settings. Method We studied patients’ preferences considering sociodemographic characteristics, diagnoses, history of psychological treatments, number of sessions, and satisfaction with past interventions. Results Most participants (85.4%) preferred psychological treatment in an individual format, 14.2% in group, and 0.4% online. When comparing the people who chose individual and group treatment, no demographic or clinical differences were found. The arguments against group format were the lack of privacy and expression difficulties. Regarding online format, these included being considered impersonal and ineffective. Conclusion The rejection of group and online psychotherapy formats allows us to define the actions we should carry out in public mental health settings to improve the acceptance of more costeffective therapy formats

Efficacy of the unified protocol for the treatment of emotional disorders in the Spanish public mental health system using a group format: study protocol for a multicenter, randomized, non-inferiority controlled trial

Background: Emotional disorders, which include both anxiety and depressive disorders, are the most prevalent psychological disorders according to recent epidemiological studies. Consequently, public costs associated with their treatment have become a matter of concern for public health systems, which face long waiting lists. Because of their high prevalence in the population, finding an effective treatment for emotional disorders has become a key goal of today ’ s clinical psychology. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders might serve the aforementioned purpose, as it can be applied to a variety of disorders simultaneously and it can be easily performed in a group format. Methods: The study is a multicenter, randomized, non-inferiority controlled clinical trial. Participants will be 220 individuals with emotional disorders, who are randomized to either a treatment as usual (individual cognitive behavioral therapy) or to a Unified Protocol condition in group format. Depression, anxiety, and diagnostic criteria are the primary outcome measures. Secondary measures include the assessment of positive and negative affect, anxiety control, personality traits, overall adjustment, and quality of life. An analysis of treatment satisfaction is also conducted. Assessment points include baseline, post-treatment, and three follow-ups at 3, 6, and 12 months. To control for missing data and possible biases, intention-to-treat and per-protocol analyses will be performed. Discussion: This is the first randomized, controlled clinical trial to test the effectiveness of a transdiagnostic intervention in a group format for the treatment of emotional disorders in public settings in Spain. Results obtained from this study may have important clinical, social, and economic implications for public mental health settings in Spain. Trial registration: Retrospectively registered at https://clinicaltrials.gov/ . Trial NCT03064477 (March 10, 2017). The trial is active and recruitment is ongoing. Recruitment is expected to finish by January 202