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Treatment of worry and comorbid symptoms within depression, anxiety, and insomnia with a group-based rumination-focused cognitive-behaviour therapy in a primary health care setting: a randomised controlled trial
Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).ORCID iD: 0000-0002-1692-8941
Kristianstad University, Sweden; Örebro University, Sweden.ORCID iD: 0000-0003-2008-0784
Örebro University, Sweden.
Kronoparken Primary Healthcare Center, Karlstad, Sweden.
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2023 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1196945Article in journal (Refereed) Published
Abstract [en]

IntroductionRepetitive negative thinking (RNT) has been described as a maintaining transdiagnostic factor for psychopathology within the areas of depression, anxiety and insomnia. We investigated the effects of rumination-focused cognitive-behaviour therapy (RF-CBT) in a group format at a primary health care centre on symptoms of depression, anxiety, insomnia, RNT, and quality of life. The participants presented clinical symptom levels of worry and at least two disorders among anxiety disorders, major depressive disorder, and insomnia disorder.MethodsA randomised controlled superiority parallel arm trial was used. 73 participants were included and randomised in pairs to either group-administered RF-CBT or a waiting list condition. The primary outcomes were self-rated worry and transdiagnostic symptoms (depression, anxiety, and insomnia). Intention-to-treat analyses of group differences were conducted using linear mixed models. Adverse side effects and incidents were presented descriptively.ResultsGroup RF-CBT significantly reduced self-reported insomnia at post-treatment and self-reported insomnia and depression at the 2 month-follow-up, relative to the wait-list control group. There was no significant difference in change in RNT, anxiety, or quality of life.DiscussionThe current study suggests that group-administered RF-CBT may be effective for insomnia and potentially effective for depression symptomatology. However, the study was underpowered to detect small and moderate effects and the results should therefore be interpreted with caution.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023. Vol. 14, article id 1196945
Keywords [en]
anxiety, depression, group therapy, insomnia, repetitive negative thinking, rumination-focused CBT
National Category
Psychiatry Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:kau:diva-97097DOI: 10.3389/fpsyg.2023.1196945ISI: 001068886700001PubMedID: 37744585Scopus ID: 2-s2.0-85171892073OAI: oai:DiVA.org:kau-97097DiVA, id: diva2:1806131
Available from: 2023-10-19 Created: 2023-10-19 Last updated: 2023-11-02Bibliographically approved

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Wallsten, DanielNorell, AnnikaTillfors, Maria

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