Transdiagnostic Treatment of Co-occurrence of Anxiety and Depressive Disorders based on Repetitive Negative Thinking: A Case Series

  • Mehdi Akbari Kharazmi University, Tehran, Iran
  • Rasool Roshan Shahed University, Tehran, Iran
  • Amir Shabani Iran University of Medical Sciences, Tehran, Iran
  • Ladan Fata Iran University of Medical Sciences, Tehran, Iran
  • Mohamad Reza Shairi Shahed University, Tehran, Iran
  • Firouzeh Zarghami Shahed University, Tehran, Iran
Keywords: Transdiagnostic Treatment, Repetitive Negative Thinking, Anxiety, Depression



Objective: The transdiagnostic cognitive behavioral treatments for treating the coexistence of anxiety and mood disorders received useful empirical supports in the recent years. However, these treatments still have moderate efficacy. Following the improvements and developments in transdiagnostic protocols and considering the importance of repetitive negative thinking as a core transdiagnostic factor in emotional disorders, this study examined a new form of transdiagnostic treatment based on Repetitive Negative Thinking (TTRNT) of co-occurrence of anxiety and depressive disorders.
Methods: Treatment efficacy was assessed using single case series with multiple baselines. Three patients meeting the criteria for co-occurrence of anxiety and depressive disorders were selected using the Anxiety Disorders Interview Schedule for DSM-IV. The patients were treated individually for 12 weekly sessions. Participants completed the standardized outcome measures during the baseline, treatment and one-month follow-up.
Results: At post-treatment, all participants showed significant clinical changes on a range of standardized outcome measures, and these gains were largely maintained through the one-month follow-up both in the principle and co-principal diagnosis.
Conclusions: Although the results of this preliminary investigation indicated that TTRNT could be a time effective and efficient treatment for individuals with co-occurrence of anxiety and depressive disorders, further controlled clinical trials are necessary to examine this new treatment approach.


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How to Cite
Akbari M, Roshan R, Shabani A, Fata L, Shairi MR, Zarghami F. Transdiagnostic Treatment of Co-occurrence of Anxiety and Depressive Disorders based on Repetitive Negative Thinking: A Case Series. Iran J Psychiatry. 10(3):200-211.