Intensive Short-Term Dynamic Psychotherapy (ISTDP) for Anxiety Diagnoses in a Primary Care Setting

Anxiety Treatment in Primary Care: an Evaluation of Intensive Dynamic Short-term Therapy

Living with anxiety often means great suffering for the person affected. The trend points to a continued increase in anxiety problems in the population, especially in the 18-44 age group. Inadequate treatment of this condition can lead to long-term sick leave, isolation, exclusion and, in the worst case, to death. The treatment methods that are available in primary care today help some but far from all. Therefore, the investigators want to scientifically evaluate a shorter version of a proven emotion-focused psychotherapy in order to increase the treatment range for this patient group. The aim of this project is to, in a primary care setting, test and evaluate an intensive, emotion-focused short-term therapy, ISTDP (Intensive Short-Term Dynamic Psychotherapy) for patients with an anxiety diagnosis. The method is well-proven on patients with more severe mental conditions (personality disorders) with good results, but the treatment has only been tested to a limited extent on patients with anxiety symptoms. The investigators want to investigate the effectiveness of treating various anxiety states for primary care patients. The treatment is expected to provide an addition to today's methods, which overall will provide better treatment results for this, increasing in number, group of patients who often seek primary care.

Study Overview

• Status: Not yet recruiting
• Conditions: Anxiety Disorders; Psychotherapy; Psychiatric &or Mood Disorder
• Intervention / Treatment: Other: Intensive Short-Term Dynamic Psychotherapy

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Annika Lundmark, MSc; Phone Number: +46480445274; Email: annika.lundmark@regionkalmar.se

Study Locations

• Sweden
  • Kalmar, Sweden, 391 85
    • Region Kalmar
    • Contact: Suzanne IM Petersson, PhD; Phone Number: +46738019547; Email: suzanne.petersson@regionkalmar.se
    • Contact: Hanna Franzén, MSc; Phone Number: +46480445274; Email: hanna.franzen1@regionkalmar.se

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Primary Care patients with primary anxiety diagnoses at a Health Care clinic in Sweden. Sufficient language competence in Swedish is required of the participants to understand, read, speak and write.

Exclusion Criteria:

• Major reading-writing and learning difficulties, severe psychiatric problems such as psychosis, eating disorder, current major depression, recurrent depression, severe trauma, acute crisis reaction, exhaustion, acute risk of suicide (assessed according to the suicide scale), addiction.
• Diagnosed specific phobia or obsessive-compulsive disorder that must be primarily treated with CBT. Concurrent psychological treatment, anxiety-relieving medication such as benzodiazepines, or recently started antidepressant treatment (< 3 months of treatment) are also exclusion criteria for participation in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treated; Participants are their own controls when they are on the waiting list before treatment, and they will later be treated with the ISTDP.	Other: Intensive Short-Term Dynamic Psychotherapy; A dynamic and intensive psychotherapy with eight therapeutic sessions

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Generalized Anxiety Disorder-7 (GAD-7) scorings	Self-report measure. The GAD-7 consists of 7 items which are scored 0-3, with a total score ranging from 0-21. Higher scores correspond to worse outcome. measures	Changes in scorings from baseline scorings to scorings after 9-10 months.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Perceived Health Questionnaire (PHQ-9) scorings	Self-report measure. The PHQ-9 consists of 9 items, which are scored from 0-3 and a total score ranging from 0-27. Higher scores correspond to worse outcome.	Changes in scorings from baseline scorings to scorings after 9-10 months.
The Panic Disorder Severity Scale (PDSS) scorings	Self-report measure. The PDSS consists of 7 items, which are scored from 0-4, with a total score ranging from 0-28. Higher scores correspond to worse outcome.	Changes in scorings from baseline scorings to scorings after 9-10 months.
The Brunnsvikens Brief Quality of Life Inventory (BBQ) scorings	Self-report measure. The BBQ has a total of 12 items covering 6 life areas. Possible total score range is 0-96. Higher scores correspond to a better outcome.	Changes in scorings from baseline scorings to scorings after 9-10 months.

Collaborators and Investigators

• Sponsor: Linnaeus University
• Collaborators: Kalmar County Hospital
• Investigators: Study Director: Cecilia Fagerström, Professor, Director of the Research Board in Region Kalmar

Study record dates

Study Major Dates

• Study Start (Estimated): September 1, 2023
• Primary Completion (Estimated): August 1, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: April 27, 2023
• First Submitted That Met QC Criteria: May 8, 2023
• First Posted (Actual): May 18, 2023

Study Record Updates

• Last Update Posted (Actual): May 31, 2023
• Last Update Submitted That Met QC Criteria: May 29, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Keywords: Psychotherapy; Clinical Research; Anxiety Disorders; Primary Care Setting
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Disease; Anxiety Disorders; Mood Disorders
• Other Study ID Numbers: LinnaeusUSP

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No