Disorder-specific versus transdiagnostic and clinician-guided versus self-guided treatment for major depressive disorder and comorbid anxiety disorders: A randomized controlled trial

J Anxiety Disord. 2015 Oct;35:88-102. doi: 10.1016/j.janxdis.2015.08.002. Epub 2015 Aug 31.


Disorder-specific cognitive behavior therapy (DS-CBT) is effective at treating major depressive disorder (MDD) while transdiagnostic CBT (TD-CBT) addresses both principal and comorbid disorders by targeting underlying and common symptoms. The relative benefits of these two models of therapy have not been determined. Participants with MDD (n=290) were randomly allocated to receive an internet delivered TD-CBT or DS-CBT intervention delivered in either clinician-guided (CG-CBT) or self-guided (SG-CBT) formats. Large reductions in symptoms of MDD (Cohen's d≥1.44; avg. reduction≥45%) and moderate-to-large reductions in symptoms of comorbid generalised anxiety disorder (Cohen's d≥1.08; avg. reduction≥43%), social anxiety disorder (Cohen's d≥0.65; avg. reduction≥29%) and panic disorder (Cohen's d≥0.45; avg. reduction≥31%) were found. No marked or consistent differences were observed across the four conditions, highlighting the efficacy of different forms of CBT at treating MDD and comorbid disorders.

Keywords: 24-month follow-up; Anxiety disorders; Disorder-specific; Internet; Major depressive disorder; Randomized controlled trial; Self- guided; Therapist-guided; Transdiagnostic; Treatment.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders / complications
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / therapy*
  • Female
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Panic Disorder / complications
  • Panic Disorder / therapy
  • Patient Satisfaction
  • Phobic Disorders / complications
  • Phobic Disorders / therapy
  • Remote Consultation / methods
  • Self Care / methods
  • Treatment Outcome
  • Young Adult