scholarly journals Thirty-year outcome of anxiety and depressive disorders and personality status: comprehensive evaluation of mixed symptoms and the general neurotic syndrome in the follow-up of a randomised controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Peter Tyrer ◽  
Helen Tyrer ◽  
Tony Johnson ◽  
Min Yang
Keyword(s):  
Randomised Controlled Trial ◽  
Panic Disorder ◽  
Controlled Trial ◽  
Anxiety And Depression ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Personality Dysfunction ◽  
Randomised Controlled ◽  
Anxiety Depression

Abstract Background Cohort studies of the long-term outcome of anxiety, depression and personality status rarely join together. Methods Two hundred and ten patients recruited with anxiety and depression to a randomised controlled trial between 1983 and 1987 (Nottingham Study of Neurotic Disorder) were followed up over 30 years. At trial entry personality status was assessed, together with the general neurotic syndrome, a combined diagnosis of mixed anxiety–depression (cothymia) linked to neurotic personality traits. Personality assessment used a procedure allowing conversion of data to the ICD-11 severity classification of personality disorder. After the original trial, seven further assessments were made. Observer and self-ratings of psychopathology and global outcome were also made. The primary outcome at 30 years was the proportion of those with no Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis. Data were analysed using multilevel repeated measures models that adjusted for age and gender. Missing data were assumed to be missing at random, and the models allowed all subjects to be included in the analysis with missing data automatically handled in the model estimation. Results At 30 years, 69% of those with a baseline diagnosis of panic disorder had no DSM diagnosis compared to 37–47% of those with generalised anxiety disorder, dysthymia or mixed symptoms (cothymia) (p = 0.027). Apart from those with no personality dysfunction at entry all patients had worse outcomes after 30 years with regard to total psychopathology, anxiety and depression, social function and global outcome. Conclusions The long-term outcome of disorders formerly called ‘neurotic’ is poor with the exception of panic disorder. Personality dysfunction accentuates poor recovery.

scholarly journals Long-term outcome of two forms of randomised benzodiazepine discontinuation

2006 ◽  
Vol 188 (2) ◽  
pp. 188-189 ◽  
Author(s):  
R. C. Oude Voshaar ◽  
W. J. M. J. Gorgels ◽  
A. J. J. Mol ◽  
A. J. L. M. Van Balkom ◽  
J. Mulder ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Usual Care ◽  
Controlled Trial ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Randomised Controlled

SummaryAbouttwo-thirds of long-term users of benzodiazepines in the population are able to discontinue this drug with the aid of supervised programmes for tapering off. Little is known about the long-term outcome of such programmes, and they have never been compared with usual care. After a 15-month follow-up of a randomised controlled trial comparing such a programme with and without psychotherapy with usual care, we found significantly higher longitudinal abstinence rates in long-term benzodiazepine users who received a benzodiazepine tapering-off programme without psychotherapy (25 out of 69, 36%) compared with those who received usual care (5 out of 33, 15%; P=0.03).

scholarly journals Long Term Outcome of Infants in a Randomised Controlled Trial of Computerised Physiological Trend Monitoring (CPTM). 77

1997 ◽  
Vol 42 (3) ◽  
pp. 398-398
Author(s):  
Steven Cunningham ◽  
Andrew G Symon ◽  
Sarah Deere ◽  
Rob Elton ◽  
Neil McIntosh
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Trend Monitoring ◽  
Randomised Controlled

The Galway Study of Panic Disorder III

1996 ◽  
Vol 168 (4) ◽  
pp. 462-469 ◽  
Author(s):  
D. O'rourke ◽  
T. J. Fahy ◽  
J. Brophy ◽  
P. Prescott
Keyword(s):  
Panic Disorder ◽  
Controlled Trial ◽  
Clinical Status ◽  
Complete Recovery ◽  
Acute Stage ◽  
Severe Illness ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Research Interview

BackgroundThe aim was to evaluate long-term outcome of DSM–III–R panic disorder at a mean of 5.3 years following a controlled trial of treatment that included antidepressants and behavioural counselling.MethodSixty-eight (86%) subjects were evaluated by lengthy research interview.ResultsThirty-four per cent recovered and remained well, 46% were minimally impaired and 20% had persistent panic disorder of whom half remained significantly impaired. Anxious–fearful personality dysfunction was the most important predictor of poor outcome, followed by poor clinical status at discharge and inability at baseline to recall vividly the initial panic attack. Those who dropped out from the original trial did badly.ConclusionsComplete recovery can occur even after many years of severe illness in a large minority of subjects who receive both antidepressants and behavioural counselling in the acute stage of treatment. The comparative prognostic value of personality, severity and chronicity need to be more fully addressed in future studies.

Long-term effectiveness of antiseptic cream for recurrent epistaxis in childhood: five-year follow up of a randomised, controlled trial

2008 ◽  
Vol 122 (10) ◽  
pp. 1084-1087 ◽  
Author(s):  
S Robertson ◽  
H Kubba
Keyword(s):  
Controlled Trial ◽  
Clinic Visit ◽  
Term Outcome ◽  
Case Record ◽  
Long Term Outcome ◽  
Recurrent Epistaxis ◽  
Randomised Controlled ◽  
Record Review

AbstractObjectives:To determine the long-term outcome for children treated for recurrent epistaxis, and to compare the efficacy of antiseptic cream treatment and nasal cautery.Study design and participants:Retrospective analytical cohort study of 88 children treated for recurrent epistaxis in 2001.Methods:Five-year data on chlorhexidine–neomycin cream usage, nasal cautery, current epistaxis frequency and emergency room attendance was collected by telephone interview and case record review.Results:During their first clinic visit, 51 per cent of the children had been treated with cautery and cream and 35 per cent with cream alone; 14 per cent had received no treatment. Five years later, 65 per cent of these children were still having ongoing epistaxis. Those who had undergone cautery and received cream had the highest ongoing bleeding rate (77 per cent).Conclusion:The majority of children treated at our clinic for recurrent epistaxis had ongoing bleeding five years later. Despite the proven short-term efficacy of chlorhexidine–neomycin cream, few patients receive further courses of cream or are referred back to the clinic.

scholarly journals Clinical efficacy of COMPASS, a digital cognitive-behavioural therapy programme for treating anxiety and depression in patients with long-term physical health conditions: a protocol for randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053971
Author(s):  
Katrin Hulme ◽  
Joanna L Hudson ◽  
Federica Picariello ◽  
Natasha Seaton ◽  
Sam Norton ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Health Conditions ◽  
Anxiety And Depression ◽  
Treatment Allocation ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Anxiety Depression

IntroductionApproximately 30% of people with long-term physical health conditions (LTCs) experience mental health problems, with negative consequences and costs for individuals and healthcare services. Access to psychological treatment is scarce and, when available, often focuses on treating primary mental health problems rather than illness-related anxiety/depression. The aim of this study is to evaluate the clinical efficacy of a newly developed, therapist-supported, digital cognitive-behavioural treatment (COMPASS) for reducing LTC-related psychological distress (anxiety/depression), compared with standard charity support (SCS).Methods and analysisA two-arm, parallel-group randomised controlled trial (1:1 ratio) with nested qualitative study will be conducted. Two-hundred adults with LTC-related anxiety and depression will be recruited through national LTC charities. They will be randomly allocated to receive COMPASS or SCS only. An independent administrator will use Qualtrics randomiser for treatment allocation, to ensure allocation concealment. Participants will access treatment from home over 10 weeks. The COMPASS group will have access to the digital programme and six therapist contacts: one welcome message and five fortnightly phone calls. Data will be collected online at baseline, 6 weeks and 12 weeks post-randomisation for primary outcome (Patient Health Questionnaire Anxiety and Depression Scale) and secondary outcomes (anxiety, depression, daily functioning, COVID-19-related distress, illness-related distress, quality of life, knowledge and confidence for illness self-management, symptom severity and improvement). Analyses will be conducted following the intention-to-treat principle by a data analyst blinded to treatment allocation. A purposively sampled group of COMPASS participants and therapists will be interviewed. Interviews will be thematically analysed.Ethics and disseminationThe study is approved by King’s College London’s Psychiatry, Nursing and Midwifery Research Ethics Subcommittee (reference: LRS-19/20–20347). All participants will provide informed consent to take part if eligible. Findings will be published in peer-reviewed journals and presented at conferences.Trial registration numberNCT04535778.

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