Treatment of Mixed Anxiety-Depression Disorder: Long-Term Outcome

2005 ◽  
Vol 34 (1) ◽  
pp. 95-101 ◽  
Author(s):  
Enrique Echeburúa ◽  
Karmele Salaberría ◽  
Paz de Corral ◽  
Raúl Cenea ◽  
Tomás Berasategui
Keyword(s):  
Drug Therapy ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Control Group ◽  
Standard Drug ◽  
Cognitive Behavioural ◽  
Anxiety Depression ◽  
Depression Disorder

The aim of this paper was to test the long-term contribution of cognitive-behavioural therapy to the treatment of mixed anxiety-depression disorder. Fifty-seven patients, selected according to DSM-IV diagnostic criteria, were assigned to: 1) cognitive-behavioural therapy; 2) combined therapy (drug and cognitive-behavioural therapy); or 3) a standard drug therapy control group. A multigroup experimental design with repeated measures of assessment (pretreatment, posttreatment, and 3-, 6- and 12 month follow-ups) was used. Most patients who were treated (71%) in experimental groups showed significant improvement at the 12-month follow-up, but there were no differences between the two therapeutic modes. No improvement was shown by the control-group participants at the 6-month follow-up. The results of the present trial do not support the beneficial effects of drug therapy by itself for this disorder. Finally, several topics that may contribute to future research in this field are discussed.

Long-term Effects of Cognitive-Behavioural Therapy and Lithium Therapy on Depression in the Elderly

1995 ◽  
Vol 167 (5) ◽  
pp. 653-658 ◽  
Author(s):  
K. C. M. Wilson ◽  
M. Scott ◽  
M. Abou-Saleh ◽  
R. Burns ◽  
J. R. M. Copeland
Keyword(s):  
Maintenance Therapy ◽  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Lithium Therapy ◽  
Controlled Study ◽  
Depression Severity ◽  
Cognitive Behavioural

BackgroundWe examine the effects of cognitive-behavioural therapy (CBT) as an adjuvant to acute physical treatment and lithium maintenance therapy in reducing depression severity over a follow-up year in elderly depressed patients.MethodThe study consists of three phases. During the acute treatment and continuation phase, 17 of 31 patients received CBT as an adjuvant to treatment as usual. During the maintenance phase of 1 year, subjects were entered into a double-blind, placebo-controlled study of low-dose lithium therapy.ResultsReceiving adjuvant CBT significantly reduced patients' scores on the Hamilton Rating Scale for Depression during the follow-up year (repeated measures analyses of variance; P = 0.007). No significant differences were found between lithium and placebo maintenance therapy.ConclusionsCBT can be adapted as an adjuvant therapy in the treatment of severely depressed elderly patients and reduces depression severity during follow-up. The prophylactic failure of long-term lithium therapy may be explained through poor compliance.

scholarly journals Long‐term benefits of digital cognitive behavioural therapy for insomnia: Follow‐up report from a randomized clinical trial

2020 ◽  
Vol 29 (4) ◽  
Author(s):  
Annemarie I. Luik ◽  
Antonia Marsden ◽  
Richard Emsley ◽  
Alasdair L. Henry ◽  
Richard Stott ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cognitive Behavioural

scholarly journals Classroom-based cognitive behavioural therapy: a large-scale non-randomised controlled trial of the ‘Journey of the Brave’

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuko Urao ◽  
Ikuyo Ohira ◽  
Takako Koshiba ◽  
Shin-ichi Ishikawa ◽  
Yasunori Sato ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Large Scale ◽  
Controlled Trial ◽  
Intervention Group ◽  
Behavioural Therapy ◽  
Anxiety Score ◽  
Small Scale ◽  
Control Group ◽  
Cognitive Behavioural

Abstract Background In Japan, ‘Journey of the Brave’, a cognitive behavioural therapy (CBT)-based anxiety preventive education programme, was previously developed and its effectiveness examined in two small-scale controlled trials. These studies had some limitations, including a small number of participants and not having regular classroom teachers as programme facilitators. Therefore, we conducted a large-scale controlled trial, with teachers as programme implementers. Methods Twenty-seven elementary schools participated: 1622 and 1123 children were allocated to the intervention and control groups, respectively. The intervention group received a programme comprising ten 45-min sessions, while the control group underwent the regular school curriculum. Anxiety symptoms among participants were assessed using the Spence Children’s Anxiety Scale (SCAS) at three stages (pre-intervention, post-intervention, and follow-up). Results Following primary analysis, estimated mean changes in SCAS from baseline to follow-up were − 4.91 (95% CI − 5.91, − 3.90) in the intervention group and − 2.53 (95% CI − 3.52, − 1.54) in the control group; the group difference was 2.37 (95% CI 1.42, 3.33, p < 0.0001). Children in the intervention group showed significant reduction in their anxiety score versus children in the control group. Conclusions The results showed a statistically significant anxiety score reduction in the intervention group, thus verifying the programme’s effectiveness. Trial registration The University Hospital Medical Information Network (UMIN): UMIN000032517. Registered 10 May 2018—Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037083

London-East Anglia randomised controlled trial of cognitive-behavioural therapy for psychosis

1998 ◽  
Vol 173 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Elizabeth Kuipers ◽  
David Fowler ◽  
Phiuppa Garety ◽  
Daniel Chisholm ◽  
Daniel Freeman ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Control Group ◽  
Service Utilisation ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundA randomised controlled trial of cognitive — behavioural therapy (CBT) for people with medication-resistant psychosis showed improvements in overall symptomatology after nine months of treatment; good outcome was strongly predicted by a measure of cognitive flexibility concerning delusions. The present paper presents a follow-up evaluation 18 months after baseline.MethodForty-seven (78% of original n=60) participants were available for follow-up at 18 months, and were reassessed on all the original outcome measures (see Part I). An economic evaluation was also completed.ResultsThose in the CBT treatment group showed a significant and continuing improvement in Brief Psychiatric Rating Scale scores, whereas the control group did not change from baseline. Delusional distress and the frequency of hallucinations were also significantly reduced in the CBT group. The costs of CB Tappear to have been offset by reductions in service utilisation and associated costs during follow-up.ConclusionsImprovement in overall symptoms was maintained in the CBT group 18 months after baseline and nine months after intensive therapy was completed. CBT may be a specific and cost-effective intervention in medication-resistant psychosis.

Long-term outcome of Internet-delivered cognitive–behavioural therapy for social phobia: A 30-month follow-up

2009 ◽  
Vol 47 (10) ◽  
pp. 848-850 ◽  
Author(s):  
Per Carlbring ◽  
Lise Bergman Nordgren ◽  
Tomas Furmark ◽  
Gerhard Andersson
Keyword(s):  
Social Phobia ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cognitive Behavioural

scholarly journals A pilot and feasibility study of a cognitive behavioural therapy-based anxiety prevention programme for junior high school students in Japan: a quasi-experimental study

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Ikuyo Ohira ◽  
Yuko Urao ◽  
Yasunori Sato ◽  
Toshiyuki Ohtani ◽  
Eiji Shimizu
Keyword(s):  
High School ◽  
Cognitive Behavioural Therapy ◽  
Junior High School ◽  
Junior High ◽  
Intervention Group ◽  
Behavioural Therapy ◽  
Control Group ◽  
School Students ◽  
Cognitive Behavioural

Abstract Background There is a good deal of evidence that cognitive behavioural therapy is effective for children and adolescents with anxiety-related problems. In Japan, an anxiety prevention programme based on cognitive behavioural therapy called ‘Journey of the Brave’ has been developed, and it has been demonstrated to be effective for elementary school students (aged 10–11 years). The purpose of this study was to have classroom teachers deliver the programme to junior high school students (aged 12–13 years) and to test the feasibility and efficacy of the programme in this setting. Methods This study was a prospective observational study and was approved by the Chiba University Review Board. An intervention group consisting of six classes of students in their first year of junior high school at two different schools (n = 149; 81 boys, 68 girls) received seven 50-min programme sessions. Participants in the control group were recruited from four classes of students in their second year of junior high school at one school (n = 89; 51 boys, 38 girls). All participants completed the Spence Children’s Anxiety Scale at pre-test, post-test, and 2–3 month follow-up. Statistical analysis was conducted using a mixed-effects model for repeated measures model. Results Mean total anxiety scores indicated a non-significant decrease at the 2–3 month follow-up for the intervention group compared to the control group. The group differences on the SCAS from baseline to post-test was − .71 (95% CI − 2.48 to 1.06, p = .43), and the 2–3 month follow-up was − .49 (95% CI − 2.60 to 1.61, p = .64). Conclusions In this pilot study, implementation of the programme confirmed the partial feasibility of the programme but did not elicit a significant reduction in anxiety scores. In addition, there are several methodological limitations to this study. In the future, we propose to test the feasibility and efficacy of the programme with the required sample size and by comparing groups with equal characteristics as well as by carrying out additional follow-up assessments. Trial registration UMIN000032517.

scholarly journals Brain connectivity changes occurring following cognitive behavioural therapy for psychosis predict long-term recovery

2017 ◽  
Vol 7 (1) ◽  
pp. e1001-e1001 ◽  
Author(s):  
L Mason ◽  
E Peters ◽  
S C Williams ◽  
V Kumari
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Affective Processing ◽  
Psychotic Symptoms ◽  
Long Term Outcomes ◽  
Functional Connections ◽  
Affective Symptoms ◽  
Cognitive Behavioural

Abstract Little is known about the psychobiological mechanisms of cognitive behavioural therapy for psychosis (CBTp) and which specific processes are key in predicting favourable long-term outcomes. Following theoretical models of psychosis, this proof-of-concept study investigated whether the long-term recovery path of CBTp completers can be predicted by the neural changes in threat-based social affective processing that occur during CBTp. We followed up 22 participants who had undergone a social affective processing task during functional magnetic resonance imaging along with self-report and clinician-administered symptom measures, before and after receiving CBTp. Monthly ratings of psychotic and affective symptoms were obtained retrospectively across 8 years since receiving CBTp, plus self-reported recovery at final follow-up. We investigated whether these long-term outcomes were predicted by CBTp-led changes in functional connections with dorsal prefrontal cortical and amygdala during the processing of threatening and prosocial facial affect. Although long-term psychotic symptoms were predicted by changes in prefrontal connections during prosocial facial affective processing, long-term affective symptoms were predicted by threat-related amygdalo-inferior parietal lobule connectivity. Greater increases in dorsolateral prefrontal cortex connectivity with amygdala following CBTp also predicted higher subjective ratings of recovery at long-term follow-up. These findings show that reorganisation occurring at the neural level following psychological therapy can predict the subsequent recovery path of people with psychosis across 8 years. This novel methodology shows promise for further studies with larger sample size, which are needed to better examine the sensitivity of psychobiological processes, in comparison to existing clinical measures, in predicting long-term outcomes.

scholarly journals Long-term effect of cognitive–behavioural therapy in patients with Hypochondriacal Disorder

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Kari-Elise Frøystad Veddegjærde ◽  
Børge Sivertsen ◽  
Jens Christoffer Skogen ◽  
Otto Robert Frans Smith ◽  
Ingvard Wilhelmsen
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Repeated Measures ◽  
Health Anxiety ◽  
Treatment Completion ◽  
Behavioural Therapy ◽  
Term Effect ◽  
Control Group ◽  
Long Term Effect ◽  
Cognitive Behavioural

Background Cognitive–behavioural therapy (CBT) is an effective treatment for Hypochondriacal Disorder, but the long-term effect has not been examined extensively. Aims To investigate the long-term effect of CBT on Hypochondriacal Disorder using several mental health measures. Follow-up time was at least 10 years. Method A total of 50 patients with a long history of Hypochondriacal Disorder, diagnosed according to ICD-10, received 16 sessions of individual CBT and were followed up with an uncontrolled design. All participants were assessed before and after the intervention period, and 10 years later. Intention-to-treat mixed-model repeated-measures analysis were conducted. The study has been registered at clinicaltrials.gov: NCT00959452. Results Patients displayed significant improvements across all outcomes, including level of health anxiety, somatisation, symptoms of anxiety and depression, quality of life, somatisation at treatment completion. Treatment gains were well maintained 10 years later. Conclusions This uncontrolled treatment study suggests that patients treated with CBT for Hypochondriacal Disorder have significantly reduced health anxiety 1 year after treatment completion and the results are maintained 10 years later. The results indicate that CBT has a lasting effect, but the lack of a control group and use of only one therapist, means that care should be taken when generalising the findings.

Long Term Follow-up of Agoraphobics Treated by Brief Intensive Group Cognitive Behavioural Therapy

1991 ◽  
Vol 25 (3) ◽  
pp. 343-349 ◽  
Author(s):  
Larry Evans ◽  
Craig Holt ◽  
Tian P.S. Oei
Keyword(s):  
Structured Interview ◽  
Treated Group ◽  
Behavioural Therapy ◽  
Panic Attacks ◽  
Control Group ◽  
Cognitive Behavioural ◽  
Long Term Follow Up ◽  
Intensive Group

This study reports the long term efficacy of a brief intensive (2 days) group cognitive behavioural programme for the treatment of agoraphobia with panic attacks. A total of 97 patients was included in the study. Seventy-four patients were in the treated group and 23 were on the waiting list control group. The Fear Questionnaire (FQ), Fear Survey Schedule (FSS), Maudsley Personality Inventory (MPI), the Hostility and Direction of Hostility Questionnaire (HDHQ) and a clinical assessment based on structured interview to assess current levels of functioning were used as dependent measures. The results show that patients in the treated group show significant improvement on FSS and FQ when compared with the patients in the control group. Clinical rating shows that 85% of the patients were either symptom free or their symptoms had been reduced and these effects of treatment were shown to be maintained at follow-up which was on average 1 year after the treatment.

The efficacy of group cognitive-behavioural therapy plus duloxetine for generalised anxiety disorder versus duloxetine alone

2019 ◽  
Vol 31 (6) ◽  
pp. 316-324
Author(s):  
Zhi-Juan Xie ◽  
Nan Han ◽  
Samuel Law ◽  
Zhi-Wen Li ◽  
Shu-Yan Chen ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Behavioural Therapy ◽  
Combined Therapy ◽  
Behavioural Therapy ◽  
Control Group ◽  
Generalised Anxiety Disorder ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Remission Rates

AbstractObjective:To explore whether and how group cognitive-behavioural therapy (GCBT) plus medication differs from medication alone for the treatment of generalised anxiety disorder (GAD).Methods:Hundred and seventy patients were randomly assigned to the GCBT plus duloxetine (n=89) or duloxetine group (n=81). The primary outcomes were Hamilton Anxiety Scale (HAMA) response and remission rates. The explorative secondary measures included score reductions from baseline in the HAMA total, psychic, and somatic anxiety subscales (HAMA-PA, HAMA-SA), the Hamilton Depression Scale, the Severity Subscale of Clinical Global Impression Scale, Global Assessment of Functioning, and the 12-item Short-Form Health Survey. Assessments were conducted at baseline, 4-week, 8-week, and 3-month follow-up.Results:At 4 weeks, HAMA response (GCBT group 57.0% vs. control group 24.4%, p=0.000, Cohen’s d=0.90) and remission rates (GCBT group 21.5% vs. control group 6.2%, p=0.004; d=0.51), and most secondary outcomes (all p<0.05, d=0.36−0.77) showed that the combined therapy was superior. At 8 weeks, all the primary and secondary significant differences found at 4 weeks were maintained with smaller effect sizes (p<0.05, d=0.32−0.48). At 3-month follow-up, the combined therapy was only significantly superior in the HAMA total (p<0.045, d=0.43) and HAMA-PA score reductions (p<0.001, d=0.77). Logistic regression showed superiority of the combined therapy for HAMA response rates [odds ratio (OR)=2.12, 95% confidence interval (CI) 1.02−4.42, p=0.04] and remission rates (OR=2.80, 95% CI 1.27−6.16, p=0.01).Conclusions:Compared with duloxetine alone, GCBT plus duloxetine showed significant treatment response for GAD over a shorter period of time, particularly for psychic anxiety symptoms, which may suggest that GCBT was effective in changing cognitive style.

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