Long-term effectiveness and prediction of treatment outcome in cognitive behavioral therapy and sertraline for late-life anxiety disorders

ABSTRACTBackground: Although anxiety disorders are prevalent in older adults, randomized controlled trials of treatment effectiveness for late-life anxiety are scarce and have focused primarily on the effectiveness of psychotherapeutic interventions. However, recent findings suggest that in some cases, pharmacological treatment may be more beneficial for late-life anxiety disorders. As yet, there have been no systematic studies investigating prognostic factors for the outcome of cognitive behavioral therapy (CBT) and pharmacotherapy for late-life anxiety. The objective of the present study was to study long-term treatment outcomes and to explore differential predictors for both short-term and long-term treatment outcomes of sertraline and CBT for late-life anxiety disorders.Methods: Participants of a randomized controlled trial (RCT) comparing sertraline and CBT for the treatment of late-life anxiety were contacted one year after completing their treatment, so that predictors for both short-term and long-term treatment outcome could be established.Results: Sertraline showed a greater reduction of symptoms than CBT on anxiety (Hamilton Anxiety Rating Scale; HARS) and worry (Worry Domain Questionnaire) ratings at one-year follow-up. The strongest predictor for short-term CBT outcome was poor perceived health, explaining 40% of the variance in post-treatment residual gain scores on the HARS. The strongest predictor for long-term CBT outcome was neuroticism, explaining 20% of the variance in residual gain scores at one-year follow-up. Analyses revealed no significant predictors for treatment outcome in sertraline participants.Conclusions: Our study suggests that long-term use of sertraline might be more beneficial for late-life anxiety than a 15-week CBT program. Poor perceived health and neuroticism are predictive of less improvement after CBT in anxious older adults. Implications of these findings are discussed.

Download Full-text

Acute and long-term treatment outcome in depressed inpatients with vs. without anxious features: Results of a one-year follow-up study

Journal of Affective Disorders ◽

10.1016/j.jad.2013.05.043 ◽

2013 ◽

Vol 150 (3) ◽

pp. 1055-1061 ◽

Cited By ~ 7

Author(s):

Stephan Köhler ◽

Theresa Unger ◽

Sabine Hoffmann ◽

Bruno Steinacher ◽

Thomas Fydrich

Keyword(s):

Treatment Outcome ◽

Term Treatment ◽

Follow Up Study ◽

Long Term Treatment ◽

One Year

Download Full-text

Mitochondrial and Oxidative Impacts of Short and Long-term Administration of HAART on HIV Patients

Current Clinical Pharmacology ◽

10.2174/1574884714666190905162237 ◽

2020 ◽

Vol 15 (2) ◽

pp. 110-124

Author(s):

Joy E. Ikekpeazu ◽

Oliver C. Orji ◽

Ikenna K. Uchendu ◽

Lawrence U.S. Ezeanyika

Keyword(s):

Treatment Group ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Hiv Patients ◽

Long Term Treatment ◽

Term Administration ◽

Short And Long Term ◽

One Year

Background and Objective: There may be a possible link between the use of HAART and oxidative stress-related mitochondrial dysfunction in HIV patients. We evaluated the mitochondrial and oxidative impacts of short and long-term administration of HAART on HIV patients attending the Enugu State University Teaching (ESUT) Hospital, Enugu, Nigeria following short and long-term therapy. Methods: 96 patients categorized into four groups of 24 individuals were recruited for the study. Group 1 comprised of age-matched, apparently healthy, sero-negative individuals (the No HIV group); group 2 consisted of HIV sero-positive individuals who had not started any form of treatment (the Treatment naïve group). Individuals in group 3 were known HIV patients on HAART for less than one year (Short-term treatment group), while group 4 comprised of HIV patients on HAART for more than one year (Long-term treatment group). All patients were aged between 18 to 60 years and attended the HIV clinic at the time of the study. Determination of total antioxidant status (TAS in nmol/l), malondialdehyde (MDA in mmol/l), CD4+ count in cells/μl, and genomic studies were all done using standard operative procedures. Results: We found that the long-term treatment group had significantly raised the levels of MDA, as well as significantly diminished TAS compared to the Short-term treatment and No HIV groups (P<0.05). In addition, there was significantly elevated variation in the copy number of mitochondrial genes (mtDNA: D-loop, ATPase 8, TRNALEU uur) in the long-term treatment group. Interpretation and Conclusion: Long-term treatment with HAART increases oxidative stress and causes mitochondrial alterations in HIV patients.

Download Full-text

Safety of dienogest in the long-term treatment of endometriosis: a one-year, open-label, follow-up study

Fertility and Sterility ◽

10.1016/j.fertnstert.2009.07.1085 ◽

2009 ◽

Vol 92 (3) ◽

pp. S107 ◽

Cited By ~ 5

Author(s):

C. Seitz ◽

C. Gerlinger ◽

T. Faustmann ◽

T. Strowitzki

Keyword(s):

Term Treatment ◽

Open Label ◽

Follow Up Study ◽

Long Term Treatment ◽

One Year

Download Full-text

P.4.041 Donepezil is a well-tolerated long-term treatment for patients with mild to moderate Alzheimer's disease: Results from a patient cohort who completed a one-year placebo-controlled study and participated in a two-year follow-up study

European Neuropsychopharmacology ◽

10.1016/s0924-977x(03)92235-8 ◽

2003 ◽

Vol 13 ◽

pp. S402-S403

Author(s):

B. Winblad ◽

K. Engedal ◽

H. Soininen ◽

F.R.J. Verhey ◽

G. Waldemar ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Term Treatment ◽

Controlled Study ◽

Patient Cohort ◽

Follow Up Study ◽

Long Term Treatment ◽

One Year

Download Full-text

Short-term Cognitive-Behavioral Therapy for Binge Eating Disorder: Long-term efficacy and predictors of long-term treatment success

Behaviour Research and Therapy ◽

10.1016/j.brat.2014.04.007 ◽

2014 ◽

Vol 58 ◽

pp. 36-42 ◽

Cited By ~ 22

Author(s):

Sophia Fischer ◽

Andrea H. Meyer ◽

Daniela Dremmel ◽

Barbara Schlup ◽

Simone Munsch

Keyword(s):

Eating Disorder ◽

Cognitive Behavioral Therapy ◽

Binge Eating ◽

Binge Eating Disorder ◽

Behavioral Therapy ◽

Treatment Success ◽

Term Treatment ◽

Short Term ◽

Long Term Treatment

Download Full-text

Outcome in Relation to Drinking Goals in Alcohol-Dependent Individuals: A Follow-up Study 2.5 and 5 Years After Treatment Entry

Alcohol and Alcoholism ◽

10.1093/alcalc/agz042 ◽

2019 ◽

Vol 54 (4) ◽

pp. 439-445 ◽

Cited By ~ 5

Author(s):

Kristina J Berglund ◽

Kerstin K Rauwolf ◽

Ulf Berggren ◽

Jan Balldin ◽

Claudia Fahlke

Keyword(s):

Treatment Outcome ◽

Severity Index ◽

Term Treatment ◽

Addiction Severity Index ◽

Low Risk ◽

Long Term Treatment ◽

Treatment Entry ◽

Alcohol Dependent

Abstract Aims To evaluate the long-term treatment outcome (up to 5 years) with respect to different drinking goals of patients. Methods Alcohol-dependent individuals (n = 349) were recruited from three alcohol treatment units. They were interviewed using the Addiction Severity Index (ASI). They were sub-grouped according to their goal at treatment entry: abstinence, low- risk drinking and no decided goal. Results Patients with abstinence as a goal at treatment entry reported at 2.5 years follow-up a higher abstinence rate, a more pronounced reduction in alcohol consumption, reduction in total number of DSM-IV criteria, higher frequency of low-risk drinking and fewer diagnoses of alcohol dependence compared to the groups who had low risk drinking as a goal or no decided goal. This improvement remained basically unchanged in all three groups at 5 years follow-up, suggesting long-term stability after the treatment interventions Conclusions The findings suggest that: (1) alcohol-dependent patients who have abstinence as their own drinking goal have a more favorable treatment outcome than those who have low-risk drinking as a goal or no decided goal. (2) Abstinence as a drinking goal should be considered for those who have a longer duration (for example more than 10 years) of their alcohol-related problems. (3) Patients who have no decided goal should be recommended abstinence as a drinking goal.

Download Full-text

A COMPARATIVE STUDY OF INTRAOCULAR PRESSURE CHANGES (OCCURING AS A SIDE EFFECT) IN LONG TERM TREATMENT OF VERNAL KERATO CONJUNCTIVITIS BY TOPICAL FLUROMETHOLONE 0.1% AND TOPICAL LOTEPREDNOL ETABONATE 0.5%

10.36106/gjra/5003623 ◽

2021 ◽

pp. 27-28

Author(s):

Kalishankar Das ◽

Sneha Bhowmick ◽

Athokpam Poireiton

Keyword(s):

Intraocular Pressure ◽

Prospective Study ◽

Term Treatment ◽

Short Term ◽

Loteprednol Etabonate ◽

Long Term Treatment ◽

A Prospective Study ◽

Pressure Changes

PURPOSE: The study aims to evaluate the safety of topical corticosteroids Loteprednol and Flurometholone in treating VKC keeping in mind the efcacy of the drugs. METHOD: A prospective study was done including 200 eyes of 107 patients with severe VKC (grade 3,4). 7 patients were lost during follow up. Patients were selected randomly. 100 eyes of 50 patients were treated with Flurometholone 1% and another 100 eyes of 50 patients with Loteprednol 0.5%. All patients were followed up over a period of 3 months. The study duration is 18 months. RESULT: The normal IOP ranging between 10-21 mm Hg. Out of 100 eyes receiving urometholone in the study period of 18 months, 3 eyes (3%) showed IOP ≥ 30mm Hg and 5 eyes (5%) showed IOP between 21-30mm Hg. Out of the rest 100 eyes receiving Loteprednol, 3 eyes (3%) showed IOP between 21-30 mm Hg while none (0%) reached an IOP over 30 mm Hg. CONCLUSION: Loteprednol is more effective than Flurometholone and it consistently demonstrated a low propensity to elevate IOP, regardless of formulation, dosage regimen both during short term as well as long term treatment of VKC patient.

Download Full-text