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While transdiagnostic cognitive behavioural therapy (TD\u2010CBT) is effective, the mechanisms underlying its long\u2010term impact on QoL remain unclear. This study examined whether changes in anxiety and depressive symptoms mediate the effect of TD\u2010CBT on QoL at 12\u2010month follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were used from the \u201cPsychology in Primary Care\u201d trial (PsicAP, from its Spanish acronym), which included 1061\u2009PC patients with anxiety and depression, randomised to TD\u2010CBT plus treatment\u2010as\u2010usual (TAU) or TAU alone. Anxiety and depression were assessed at baseline, post\u2010treatment and 6\u2010month follow\u2010up. QoL was measured at baseline and 12\u2010month follow\u2010up. Path analyses using structural equation modelling (SEM) were used to study direct and indirect effects, controlling for baseline scores and gender.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TD\u2010CBT significantly reduced anxiety and depression immediately post\u2010treatment compared to TAU. The only significant indirect effect on 12\u2010month QoL across all dimensions operated sequentially through sustained reductions in depressive symptoms. No significant mediation was found via anxiety symptoms. No specific temporal sequence of symptom improvement mediating QoL was identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>TD\u2010CBT improves anxiety and depressive symptoms at post\u2010treatment; nevertheless, long\u2010term QoL improvement occurs primarily through sustained reduction in depressive symptoms and through the direct effects of treatment itself. These findings support the implementation of TD\u2010CBT in PC to achieve lasting functional recovery, highlighting the crucial role of addressing and sustaining improvements in depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/da\/1601969","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T06:37:49Z","timestamp":1770446269000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Transdiagnostic Cognitive Behavioural Therapy on Long\u2010Term Quality of Life: A Causal Mediation Analysis Across Anxiety and Depressive 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