A systematic review and meta-analysis of transdiagnostic interventions for common mental disorders in primary care

Objective: In primary care, treating common mental disorders according to the ICD or DSM is challenging. A transdiagnostic approach may facilitate the management of mental health problems by treating across psychiatric diagnoses. This meta-analysis aims to identify and compare transdiagnostic interventions delivered in primary care and to determine the effectiveness of these interventions, focusing on common mental disorders.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted by searching the databases Medline, Embase, Web of Science, and PsycINFO. Standardized mean differences (SMD) were calculated for the outcomes, and additional subgroup analyses were performed.

Results: From an initial set of 10,618 RCTs, 38 studies were included and retained for data extraction. Transdiagnostic interventions led to a significant reduction in symptoms of depression (SMD: -0.38) and anxiety (SMD: - 0.47). Treatment outcomes for somatoform disorders were not significant (SMD: - 0.22). About half of the interventions were provided by health professionals not specifically trained in psychotherapy; these interventions also proved to be effective (depression: SMD: -0.47; anxiety: -0.39).

Conclusion: This meta-analysis supports the use of transdiagnostic interventions for common mental disorders in primary care. Transdiagnostic interventions carried out by medical and health professionals not specifically trained in psychotherapy are feasible in PC, but emphasis should be placed on adequate training for them.

Trial registration: The protocol for this study is registered with PROSPERO: CRD42024459073, Date of registration: 2024/01/03.