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En jämförelse mellan två ultrakorta interventioner i primärvården för patienter med ångest, depression och stress. (RNTACTSweden)

18 september 2026 uppdaterad av: Region Skane

A Comparison of Two Ultra-brief Interventions in Primary Care for Patients With Anxiety, Depression, and Stress: a Pilot Randomized Controlled Trial.

This pilot randomized controlled trial evaluated the feasibility of a Swedish translation of an Acceptance and Commitment Therapy protocol targeting repetitive negative thinking (RNT-ACT) compared with therapist-supported internet-based cognitive behavioral therapy (iCBT) in Swedish primary care. Feasibility was assessed in terms of recruitment, intervention completion, and patient satisfaction. Symptoms of depression, anxiety and stress, rumination, psychological flexibility, valued living, and cognitive fusion were assessed as secondary outcomes.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

This pilot randomized controlled trial was conducted to evaluate the feasibility of RNT-ACT in Swedish primary care, using therapist-supported iCBT as an active comparator. Participants were randomized to either RNT-ACT or iCBT.

RNT-ACT consisted of two 60-minute therapy sessions and audio exercises for participants to use between sessions. Participants allocated to iCBT received an internet-based cognitive behavioral therapy program for anxiety or depression, delivered through the secure Stöd och Behandling platform used in Region Skåne, with therapist support available through the platform.

The primary feasibility outcomes were recruitment rate, intervention non-completion, and patient satisfaction measured with the Client Satisfaction Questionnaire (CSQ-8). Secondary outcomes included symptoms of depression, anxiety and stress, rumination, psychological flexibility, valued living, and cognitive fusion. Secondary outcomes were included to describe the sample and patterns of change and were not intended to provide evidence of comparative treatment efficacy.

Studietyp

Interventionell

Inskrivning (Faktisk)

13

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Sverige
    • Skåne County
      • Helsingborg, Skåne County, Sverige, 254 83
        • Vårdcentralen Laröd

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • DASS-21 total score >20
  • Ability to communicate in spoken and written Swedish

Exclusion Criteria:

  • Physical illness requiring further medical assessment identified during routine screening
  • Ongoing psychological or psychiatric treatment
  • A level of suicide risk considered clinically incompatible with study participation
  • Substance abuse
  • Anorexia nervosa
  • Psychotic disorder
  • Bipolar disorder
  • Attention-deficit/hyperactivity disorder (ADHD)
  • Antisocial personality disorder
  • A level of exhaustion considered incompatible with study participation

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: RNT-ACT protocol

Participants randomized to RNT-ACT will receive a total of 2 sessions of 60 minutes each as well as audio files to listen to between the occasions administered via internet. Previous studies have indicated that it doesn't make much of a difference whether the temporal distance between session 1 and session 2 is between 1 week and up to 3 months. At occasion 1, the time for occasion 2 is set. The temporal distance in days will noted for each patient. The treatment is inserted into the therapist's regular diary with 60 minutes session time and appropriate break before and after the treatment (e.g. at least 5-10 minutes) for preparation and post-administration where journal writing is included.
Beteende: RNT-ACT Protocol

Swedish Translation of the 2*60 minute Acceptance and Commitment Protocol for Repetitive Negative Thinking.

Andra namn:
  • Acceptance and Commitment Therapy (ACT)
Aktiv komparator: iCBT treatment

The people randomized to Internet treatment will be offered based on M.I.N.I 7.0 a suitable iCBT program in the Stöd och Behandling (SoB) platform. The patients follow a structured self-help material which can be seen as a standard treatment option in Region Skåne, "treatment as usual". The therapist has access to the material and the patient and the therapist can communicate via a chat function. The patients are matched to iCBT programs based on whether they are most likely to show symptoms of depression or anxiety. The main component of Internet processing consists of a structured self-help program in approximately eight modules, somewhat varying depending on which program in use. The program is based on proven CBT interventions for each problem area with a strong emphasis on psychoeducation but where different intervention elements is included.
Beteende: iCBT Treatment

Therapist-supported internet-based Cognitive Behavioral Therapy (iCBT), provided as part of routine care in Swedish primary care and used as the active comparator.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Recruitment rate
Tidsram: At screening and enrolment.

Percentage of participants enrolled among all individuals screened for participation. Calculated as the number of participants enrolled divided by the total number of individuals screened, multiplied by 100.
At screening and enrolment.
Intervention non-completion rate
Tidsram: From randomization through completion of the allocated intervention, up to approximately 3 months.

Percentage of randomized participants who did not complete their allocated intervention. Intervention completion was assessed as a binary outcome.
From randomization through completion of the allocated intervention, up to approximately 3 months.
CSQ-8
Tidsram: At the main post-treatment follow-up; if not completed, at the 3-month follow-up.

Client Satisfaction Questionnaire (CSQ-8). Min 8, Max 32 with higher values indicating higher satisfaction.
At the main post-treatment follow-up; if not completed, at the 3-month follow-up.

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
DASS-21
Tidsram: At baseline, main post-treatment follow-up, and 3-month follow-up.

Depression, Anxiety and Stress Scale-21 (DASS-21); Min 0, Max 63, with higher values indicating greater psychological distress.
At baseline, main post-treatment follow-up, and 3-month follow-up.
RRS-BR
Tidsram: At baseline, main post-treatment follow-up, and 3-month follow-up.

Ruminative Responses Scale - Brooding and Reflection (RRS-BR). Total score range 10-40, with higher values indicating a greater tendency to ruminate.
At baseline, main post-treatment follow-up, and 3-month follow-up.
SAAQ
Tidsram: At baseline, main post-treatment follow-up, and 3-month follow-up.

Swedish Acceptance and Action Questionnaire (SAAQ). Total score range 6-42, with higher values indicating greater psychological inflexibility.
At baseline, main post-treatment follow-up, and 3-month follow-up.
Valuing Questionnaire (VQ)
Tidsram: At baseline, main post-treatment follow-up, and 3-month follow-up.

Valuing Questionnaire (VQ). A 10-item self-report measure of valued living comprising two subscales, Progress and Obstruction, five items each. Each subscale has a score range of 5-35. Higher Progress scores and lower Obstruction scores indicate greater valued living. Each item is rated on a seven-point Likert-type scale ranging from 1 (Not at all true) to 7 (Completely true).
At baseline, main post-treatment follow-up, and 3-month follow-up.
CFQ-7
Tidsram: At baseline, main post-treatment follow-up, and 3-month follow-up.

Cognitive Fusion Questionnaire - 7 items (CFQ-7). Total score range 7-49, with higher values indicating greater cognitive fusion.
At baseline, main post-treatment follow-up, and 3-month follow-up.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Region Skane

Samarbetspartners

Lund University

Utredare

  • Huvudutredare: Veronica Milos Nymberg, PhD, Lund University/Region Skåne

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Användbara länkar

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

7 februari 2024

Primärt slutförande (Faktisk)

20 december 2024

Avslutad studie (Faktisk)

25 maj 2025

Studieregistreringsdatum

Först inskickad

22 juni 2023

Först inskickad som uppfyllde QC-kriterierna

6 juli 2023

Första postat (Faktisk)

14 juli 2023

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

22 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

18 september 2026

Senast verifierad

1 augusti 2026

Mer information

Termer relaterade till denna studie

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 2022-06465-01

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