Generalized Anxiety Disorder and Comorbid Symptoms of Sleep: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders

Generalized anxiety disorder (GAD) has high comorbidity with other psychological disorders and causes functional impairments. A unified protocol (UP) for transdiagnostic treatment is an emotion-based treatment and can be effective in improving comorbid symptoms. This study aimed at evaluating the effectiveness of UP for transdiagnostic treatment and pharmacotherapy treatment-as-usual (UP + TAU) compared with pharmacotherapy treatment-as-usual (TAU) in reducing the symptoms of GAD and comorbid sleep problems. The present study was a clinical trial and the statistical population of this study consisted of all the people with GAD referred to mental health clinics in Kermanshah, Iran. The participants were 24 individuals with GADs and their comorbid symptoms (sleep problems) and were randomly assigned to control (TAU) and experimental groups (UP + TAU). The participants completed the Penn State Worry Questionnaire (PSWQ), Pittsburgh Sleep Quality Index ‎ (PSQI), and Work and Social Adjustment Scale (WSAS) in the three stages of assessment. One-way analysis of covariance (ANCOVA) was used to analyze the data. Among the participants in the TAU + UP group, the symptoms of GAD and sleep problems (only in follow-up) significantly decreased and overall performance improved in comparison to the TAU group (P > 0.001). However, this significant effect was shown only in some of the components of sleep quality. Based on the findings of this study, UP was effective in reducing the symptoms of GAD and its comorbid symptoms (sleep problems), and improving overall performance. However, the reduction in sleep problems (only in a few components) was statistically significant only at the follow-up stage.