Effectiveness and Acceptability of the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in People With Long COVID-19.

The COVID-19 disease has caused one of the largest pandemics in history, with significant health, social, and economic negative consequences. A significant proportion of the population has not overcome these negative consequences. It has been found that 10-20% of patients with COVID-19 do not recover their previous health status and develop persistent symptoms over time. This condition has been defined by the WHO as post-COVID-19 condition or long COVID-19, characterized by the presence of physical, cognitive, and emotional symptoms that can last for months or even years after the acute COVID-19 infection. Some of the most prevalent symptoms are fatigue, difficulty breathing, and cognitive dysfunction, in addition to significant psychological impairments. Among these, emotional disorders (ED) are the most commonly reported in this population, including anxiety disorders, depressive disorders, and related conditions.

The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP) is a transdiagnostic Cognitive Behavioral Therapy-based pychological intervention, which has proven to be effective for the treatment of emotional disorders in different populations. The UP is focused on improving emotion regulation skills.

The main objective of this randomized controlled trial is to evaluate the effectiveness and acceptability of the Unified Protocol (UP) in an online group format for the treatment of emotional disorders in 90 adults (45 in the control group and 45 in the experimental group) with long COVID and a comorbid emotional disorder. The researchers hypothesize that the application of the UP will result in a significant reduction in emotional symptoms in the experimental group, compared to the control group. To analyze this results, the evolution of symptoms (i.e., anxiety and depressive symptoms, etc.) will be assessed over time (before and after the intervention, as well as up to 12 months follow-up). Additionally, the acceptability and satisfaction of participants after receiving the UP will be analyzed, and it will be examined whether changes in emotional symptoms are associated with changes in long COVID physical symptoms. Changes in cortisol and cortisona levels will be longitudinally examined in the experimental group.

• Memory Failures of Everyday, MFE (Sunderland et al., 1983; Montejo et al., 2014) [Срок оценки: Before the treatment, after the treatment, at three points follow up (3, 6 and 12 months after the intervention ended)]
• Multidimensional Inventory for Emotional Disorders (MEDI; Rosellini and Brown, 2019. Validated in Spanish by Osma et al., 2023) [Срок оценки: Before the treatment, after the treatment, at three points follow up (3, 6 and 12 months after the intervention ended)]
• Emotional Regulation Difficulties Scale (DERS; Gratz and Roemer, 2004. Validated in Spanish by Hervás & Jódar, 2008) [Срок оценки: Before the treatment, after the treatment, at three points follow up (3, 6 and 12 months after the intervention ended)]
• EuroQol (Brooks, 1996. Validated in Spanish by Badia et al., 1999) [Срок оценки: Before the treatment, after the treatment, at three points follow up (3, 6 and 12 months after the intervention ended)]
• Distress Tolerance Scale (DTS; Sandín et al., 2017) [Срок оценки: Before the treatment, after the treatment, at three points follow up (3, 6 and 12 months after the intervention ended)]
• Perceived Stress Scale (PSS; Remor y Carrobles, 2001) [Срок оценки: Before the treatment, after the treatment, at three points follow up (3, 6 and 12 months after the intervention ended)]
• An adaptation of Client Satisfaction Questionnaire (CSQ-8) of Larsen et al., 1979) [Срок оценки: After the treatment is applied (post-assessment; approximately 12 weeks after the intervention starts)]
• Evaluation questionnaire of the UP modules (Ad hoc) [Срок оценки: After the treatment is applied (post-assessment; approximately 12 weeks after the intervention starts)]
• Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005) [Срок оценки: Only in the experimental group: Before the treatment; at two points follow up (3 and 12 months after the intervention ended)]
• Digit Symbol subtest-Wechsler Adult Intelligence Scale-III (WAIS-III; Wechsler, 1997) [Срок оценки: Only in the experimental group: Before the treatment; at two points follow up (3 and 12 months after the intervention ended)]
• Digit subtest from Wechsler Adult Intelligence Scale-IV (WAIS-IV; Wechsler, 2008) [Срок оценки: Only in the experimental group: Before the treatment; at two points follow up (3 and 12 months after the intervention ended)]
• Cortisol and cortisona levels [Срок оценки: Only in the experimental group: Before the treatment; at two points follow up (3 and 12 months after the intervention ended)]