The short- and long-term effect of duloxetine on painful physical symptoms in patients with generalized anxiety disorder: Results from three clinical trials

Generalized anxiety disorder (GAD) is a debilitating condition characterized by excessive, pervasive, uncontrollable, and paralyzing worries about a wide range of future situations. Individuals with this condition frequently find themselves stuck in worry and tension cycles in futile attempts at reducing uncertainty and increasing control. GAD has been associated with substantial impairments in functioning and reduced quality of life. GAD remains poorly understood, and the long-term efficacy and end-state functioning resulting from treatment are weaker compared to other anxiety disorders. Some treatments (e.g., emotion regulation therapy, acceptance-based behavioral therapy) have improved efficacy, partly by targeting emotional dysfunction. Basic psychopathology research has focused on identifying the role of negative affect in GAD, so little is known about how positive affect is experienced and regulated in this disorder. This is particularly important in light of the overlap of this condition with major depressive disorder, which is characterized by low or suppressed positive emotion. Developing such an understanding is essential to further improve the efficacy of emotion-based treatments. This chapter reviews current and future directions in the study of positive affect in GAD. The chapter reviews the nascent research on positive affect and GAD, then illustrates dimensions of future work.

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Short- and Long-Term Effect of Surgically Assisted Maxillary Expansion on Nasal Airway Size

Journal of Craniofacial Surgery ◽

10.1097/01.scs.0000234987.84615.0c ◽

2006 ◽

Vol 17 (6) ◽

pp. 1045-1049 ◽

Cited By ~ 20

Author(s):

Gi??dre Berretin-Felix ◽

Renata Paciello Yamashita ◽

Hugo Nary Filho ◽

Eduardo Sanches Gonales ◽

Alceu Sergio Trindade ◽

...

Keyword(s):

Term Effect ◽

Nasal Airway ◽

Maxillary Expansion ◽

Long Term Effect ◽

Short And Long Term

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Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials

Psychological Medicine ◽

10.1017/s0033291702007079 ◽

2003 ◽

Vol 33 (3) ◽

pp. 499-509 ◽

Cited By ~ 52

Author(s):

R. C. DURHAM ◽

J. A. CHAMBERS ◽

R. R. MACDONALD ◽

K. G. POWER ◽

K. MAJOR

Keyword(s):

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Secondary Care ◽

Generalized Anxiety ◽

Behaviour Therapy ◽

Term Outcome ◽

Long Term Outcome ◽

Cognitive Behaviour

Background. Generalized anxiety disorder is a common condition of excessive worry and tension which tends to run a chronic course associated with significant psychiatric and medical problems. Cognitive behaviour therapy (CBT) has been shown to be of clinical value in about 50% of cases with treatment gains maintained over follow-up periods ranging from 6 to 12 months. The potential value of CBT over the longer term has not been subject to rigorous investigation.Method. Results are reported of 8–14 year follow-up of two randomized controlled trials of cognitive-behaviour therapy for generalized anxiety disorder employing structured interview with an assessor blind to initial treatment condition. Comparison groups included medication and placebo in one study based in primary care, and analytical psychotherapy in the other based in secondary care. Follow-up samples (30% and 55% of trial entrants) were broadly representative of the original cohorts.Results. Overall, 50% of participants were markedly improved of whom 30–40% were recovered (i.e. free of symptoms). Outcome was significantly worse for the study based in secondary care in which the clinical presentation of participants was more complex and severe. For a minority (30–40%), mainly from the secondary care study, outcome was poor. Treatment with CBT was associated with significantly lower overall severity of symptomatology and less interim treatment, in comparison with non-CBT conditions, but there was no evidence that CBT influenced diagnostic status, probability of recovery or patient perceptions of overall improvement.Conclusions. Both CBT and the complexity and severity of presenting problems appear to influence the long-term outcome of GAD.

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