scholarly journals Generalized Anxiety Disorder 7-Item (GAD-7) Scores in Medically Authorized Cannabis Patients—Ontario and Alberta, Canada

2021 ◽  
pp. 070674372110433
Author(s):  
Cerina Lee ◽  
Jessica M. Round ◽  
John G. Hanlon ◽  
Elaine Hyshka ◽  
Jason R.B. Dyck ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Current Evidence ◽  
P Value ◽  
Generalized Anxiety ◽  
Medical Cannabis ◽  
Time Period ◽  
Clinically Significant ◽  
Over Time

Objectives Despite increasing rates of legalization of medical cannabis worldwide, the current evidence available on its effect on mental health outcomes including anxiety is of mixed results. This study assesses the effect of medical cannabis on generalized anxiety disorder 7-item (GAD-7) scores in adult patients between 2014 and 2019 in Ontario and Alberta, Canada. Methods An observational cohort study of adults authorized to use medical cannabis. The GAD-7 was administered at the time of the first visit to the clinic and subsequently over the follow-up time period of up to 3.2 years. Overall changes in GAD-7 scores were computed (mean change) and categorized as: no change (<1 point); improvement; or worsening—over time. Results A total of 37,303 patients had initial GAD-7 scores recorded and 5,075 (13.6%) patients had subsequent GAD-7 follow-up scores. The average age was 54.2 years (SD 15.7 years), 46.0% were male, and 45.6% noted anxiety symptoms at the baseline. Average GAD-7 scores were 9.11 (SD 6.6) at the baseline and after an average of 282 days of follow-up (SD 264) the average final GAD-7 score recorded was 9.04 (SD 6.6): mean change −0.23 (95% CI, −0.28 to −0.17, t[5,074]: −8.19, p-value <0.001). A total of 4,607 patients (90.8%) had no change in GAD-7 score from their initial to final follow-up, 188 (3.7%) had a clinically significant decrease, and 64 (1.3%) noted a clinically significant increase in their GAD-7 scores. Conclusions Overall, there was a statistically significant decrease in GAD-7 scores over time (in particular, in the 6–12-month period). However, this change did not meet the threshold to be considered clinically significant. Thus, we did not detect clinical improvements or detriment in GAD-7 scores in medically authorized cannabis patients. However, future well-controlled clinical trials are needed to fully examine risks or benefits associated with using medical cannabis to treat anxiety conditions.

ONE YEAR FOLLOW-UP OF COGNITIVE THERAPY, ANALYTIC PSYCHOTHERAPY AND ANXIETY MANAGEMENT TRAINING FOR GENERALIZED ANXIETY DISORDER: SYMPTOM CHANGE, MEDICATION USAGE AND ATTITUDES TO TREATMENT

1999 ◽  
Vol 27 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Robert C. Durham ◽  
Peter L. Fisher ◽  
Linda R. Trevling ◽  
Cathryn M. Hau ◽  
Karen Richard ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Cognitive Therapy ◽  
Generalized Anxiety Disorder ◽  
Management Training ◽  
Generalized Anxiety ◽  
Medication Usage ◽  
Anxiety Management ◽  
Clinically Significant ◽  
One Year

A one year follow-up is reported of a randomized clinical trial with generalized anxiety disorder (GAD) in which the main comparison was between analytic psychotherapy (AP) and cognitive therapy (CT), each delivered at weekly or fortnightly intervals over a six month period. CT was found to be significantly more effective than AP. However, GAD is a chronic and relapsing condition and follow-up data are needed to assess the durability of improvement and the possibility that the benefits of analytic psychotherapy may be more apparent over the longer term. Data were collected in three areas: (1) symptomatology and overall improvement; (2) medication usage and contact with GPs; and (3) attitudes to therapy. CT was clearly superior to AP on the main outcome measures and only a minority of AP patients made significant improvements. CT but not AP was associated with significant reductions in medication usage, and patients receiving CT were generally more positive about treatment received. Differences between treatments were less evident in the less intensive treatment condition where overall results were relatively poor. The most positive outcomes were achieved in the more intensive CT condition in which approximately two-thirds of patients achieved clinically significant improvements.

Recovery rates in generalized anxiety disorder following psychological therapy: an analysis of clinically significant change in the STAI-T across outcome studies since 1990

1999 ◽  
Vol 29 (6) ◽  
pp. 1425-1434 ◽  
Author(s):  
PETER L. FISHER ◽  
ROBERT C. DURHAM
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Psychological Therapy ◽  
Generalized Anxiety ◽  
Recovery Rates ◽  
Clinically Significant Change ◽  
Treatment Conditions ◽  
Significant Change ◽  
Clinically Significant

Background. There have been six randomized controlled trials of psychological therapy with generalized anxiety disorder (GAD) using DSM-III-R and DSM-IV. All have used the Trait version of the Spielberger State–Trait Anxiety Inventory (STAI-T) as one of several outcome measures. Each study, however, employed different methods of calculating the clinical significance of outcomes making it difficult to reach a balanced appraisal of the efficacy of psychological treatment.Methods. Raw data on STAI-T scores at pre-, post- and follow-up were obtained for each of the six studies (total N=404). Jacobson methodology for defining clinically significant change (criterion c, reliable change index = 8, cut-off point = 46) was used to allocate each patient to one of four outcomes: worse, unchanged, improved and recovered. The proportion of patients in each category was calculated for treatment conditions in each study and also for aggregate data across types of treatment.Results. A recovery rate of 40% was found for the sample as a whole with 12 of the 20 treatment conditions obtaining very modest recovery rates of 30% or less. Two treatment approaches – individual cognitive behavioural therapy and applied relaxation – do relatively well with overall recovery rates at 6-month follow-up of 50–60%.Conclusions. Jacobson methodology, in distinguishing between improvement and recovery on a standardized measure of general vulnerability to anxiety, provides a stringent but clinically more meaningful evaluation of the efficacy of psychological therapies with GAD than has been available hitherto. Systematic focus on either excessive worry or physiological arousal gives worthwhile results.

scholarly journals Anxiety in middle adulthood: effects of age and time on the 14-year course of panic disorder, social phobia and generalized anxiety disorder

2008 ◽  
Vol 39 (4) ◽  
pp. 615-624 ◽  
Author(s):  
H. J. Ramsawh ◽  
S. D. Raffa ◽  
M. Orlando Edelen ◽  
R. Rende ◽  
M. B. Keller
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Social Phobia ◽  
Generalized Anxiety Disorder ◽  
Short Interval ◽  
Outcome Variable ◽  
Generalized Anxiety ◽  
Over Time

BackgroundMuch about the long-term course of anxiety disorders is unknown. The present study utilizes a naturalistic, longitudinal, short-interval follow-up design to elucidate the course of anxiety disorders over 14 years in a largely middle-aged adult sample recruited from out-patient psychiatry and primary care facilities.MethodThe sample consisted of 453 participants with a diagnosis of panic disorder (PD), social phobia (SP) and/or generalized anxiety disorder (GAD). Anxiety symptom ratings were tracked using weekly psychiatric status ratings (PSRs). Controlling for demographic and clinical variables, the course of PD, GAD and SP were examined using longitudinal growth models, with the most severe PSR at each follow-up point as the main outcome variable.ResultsPSRs significantly decreased in severity over time in each of the three disorders. In the interaction effects models, age×time had a significant effect on course for PD and GAD, but not for SP, in that older age was associated with lower PSRs over time.ConclusionsThe present findings suggest that the severity of anxiety disorders declines over time, although this decline is modest and depends on the specific disorder being assessed. Older individuals with PD and GAD have a better prognosis than their younger counterparts, as their course is characterized by a steeper decline in severity. The present findings provide important information about the course of anxiety disorders in mid-life.

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

2003 ◽  
Vol 33 (3) ◽  
pp. 499-509 ◽  
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.

scholarly journals A single-center study on impact of psychological intervention to acclimatize medical staffs who are serving COVID-19 disease patients, to continue hospital activities without any disruption

2021 ◽  
Vol 8 (6) ◽  
pp. 3048
Author(s):  
Dhaval Dalal ◽  
Kamalpriya Thiyagarajan ◽  
Humeshwari Nipane ◽  
Vijaykumar Gawali
Keyword(s):  
Health Care ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Health Care Workers ◽  
Psychological Intervention ◽  
P Value ◽  
Generalized Anxiety ◽  
Chi Square ◽  
Care Workers ◽  
Chi Square Test

Background: COVID-19 has brought psychological disorders that affect health care workers and the general public. Hence it is important to have necessary counselling to address the psychological, social aspects of the pandemic to ensure psychological well-being of especially Health-care Workers and preserve their innate and acquired immunity.Methods: The study was planned as single centre retrospective study and conducted between April and June 2020 at dedicated COVID-19 hospital in India. Front-line HCWs more than 18 years, of any gender working in COVID-19 hospital and willing to participate for the study were enrolled in the study. Study included two questionnaires, generalized anxiety disorder scale, and socio-demographics and COVID-19 related awareness questionnaire. Measurements were taken pre and post the psychological counselling intervention.Results: As per generalized anxiety disorder (GAD) scale people suffering from moderate anxiety disorder dropped from 19% (pre counselling) to 5% (post counselling) and severe cases dropped from 14% (pre counseling) to 2% (post counseling), there was statistically significant difference observed due to psychological intervention in GAD scale (Chi square test-10.794, p value=3.67E-27). Socio demographics and COVID-19 related awareness questionnaire results were statistically significant (Chi square test-11.945, p value=6.91E-33).Conclusions: Counselling interventions based on scientific data offered in groups by investigator with an accurate knowledge of the COVID-19 and its manifestation increased the confidence of health care workers (HCWs) and reduced anxiety level. This was translated into the full availability of HCWs on the clinical study site, although medical services were disrupted while other hospitals were starving due to lack of staff.

scholarly journals Effectiveness of Cognitive-Behavioral Therapy (CBT) on Quality of Life (QOL) and Worry in Patients with Generalized Anxiety Disorder (GAD)

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Sheida Jabalameli ◽  
Hamid Taher Neshat Doost ◽  
Mohammad Bagher Kajbaf ◽  
Hossein Molavi
Keyword(s):  
Quality Of Life ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Behavioral Therapy ◽  
Control Group ◽  
Generalized Anxiety ◽  
The Mean ◽  
Experimental Group

Generalized Anxiety Disorder (GAD) is one of the most common anxiety disorders. It has been reported that psychological treatments like Cognitive-Behavioral Therapy (CBT) is effective for patients with GAD. The purpose of the present research was to investigate the effectiveness of CBT on Quality of Life (QOL) and worry in patients with GAD. A sample of 30 patients with GAD who had been referred to psychiatry offices in Isfahan, Iran were selected and assigned into an experimental group (n=15) and a control group (n=15) randomly.  The experimental group received CBT in 8 weekly sessions. All participants completed the World Health Organization Quality Of Life-Brief (WHOQOL-BREF) questionnaire and the Penn State Worry Questionnaire (PSWQ) at pretest, posttest and follow up. The results of MANCOVA showed that the mean scores of QOL in the experimental group was significantly higher than the control group at the posttest and follow up (P<0.05) and the mean scores of worry in the experimental group was significantly lower than the control group at the posttest and follow up (P<0.05) It is concluded that CBT can be applied for the patients with GAD as a useful psychological treatment. In general, CBT can improve QOL and decrease worry in patients with GAD.

scholarly journals Psychosocial factors associated with symptoms of generalized anxiety disorder in general practitioners during the COVID-19 pandemic

2020 ◽  
Vol 68 (7) ◽  
pp. 1228-1234 ◽  
Author(s):  
Alvaro Monterrosa-Castro ◽  
Velia Redondo-Mendoza ◽  
María Mercado-Lara
Keyword(s):  
Anxiety Disorder ◽  
General Practitioners ◽  
Generalized Anxiety Disorder ◽  
Healthcare Providers ◽  
Demographic Factors ◽  
Female Gender ◽  
P Value ◽  
Generalized Anxiety ◽  
Health Providers ◽  
Cross Sectional

Healthcare providers commonly experience symptoms of anxiety during public health crises and pandemics. The objective of the study was to identify the frequency of symptoms of generalized anxiety disorder (GAD) in general practitioners and to estimate the association with particular psychosocial and demographic factors. This is a cross-sectional study, where a total of 531 general practitioners completed an online form that contained sociodemographic variables, questions about fear and perceptions concerning medical work during the COVID-19 pandemic, 7-Item Generalized Anxiety Disorder Scale (GAD-7), questionnaire on psychosomatic problems and Fear of COVID-19 Scale. The presence of symptoms of GAD was defined by a GAD-7 score of 10 or more points. Voluntary and anonymous participation, acceptance of terms, and informed consent were requested. A p value of <0.05 was considered statistically significant. Symptoms of GAD were identified in 4 out of 10 Colombian general practitioners; the following psychosocial and demographic factors were associated with a greater presence of these symptoms: female gender, social discrimination, anguish, job disappointment, nightmares, stress and other symptoms of fear regarding the pandemic. Conversely, feeling protected by the state or employer, being satisfied with their job as a physician, and trusting government measures and information were associated with a lower presence of symptoms of GAD. These findings highlight the importance of timely psychotherapeutic and psychopharmacological interventions in these individuals. The authors suggest mental health providers should be deployed during times of crisis to decrease the risk of developing mental illness.

A follow-up study of cognitive bias in generalized anxiety disorder

1995 ◽  
Vol 33 (8) ◽  
pp. 927-935 ◽  
Author(s):  
Karin Mogg ◽  
Brendan P. Bradley ◽  
Neil Millar ◽  
Jim White
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Cognitive Bias ◽  
Generalized Anxiety ◽  
Follow Up Study

A 5-Year Follow-up Study of Generalized Anxiety Disorder and Panic Disorder

1999 ◽  
Vol 187 (1) ◽  
pp. 3-9 ◽  
Author(s):  
CATHERINE L. WOODMAN ◽  
RUSSELL NOYES ◽  
DONALD W. BLACK ◽  
STEVE SCHLOSSER ◽  
STEPHEN J. YAGLA
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Follow Up Study

Comparison of Two Cognitive Strategies in Treatment of a Patient with Generalized Anxiety Disorder

1983 ◽  
Vol 53 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Cynthia G. Last ◽  
David H. Barlow ◽  
Gerald T. O'Brien
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Cognitive Strategies ◽  
Cognitive Strategy ◽  
Generalized Anxiety ◽  
Differential Effectiveness ◽  
Patient Reported ◽  
Alternating Treatment Design ◽  
Treatment Design

The relative efficacy of two cognitive strategies—coping self-statements and paradoxical intention—for reducing anxiety were compared using an alternating treatment design for a patient with generalized anxiety disorder. While cognitive restructuring appeared to be effective clinically in treating this patient, results did not suggest an advantage in effectiveness of one cognitive strategy over the other. However, although measures did not indicate a differential effectiveness between the two cognitive strategies, the patient reported that she found the coping self-statement strategy more helpful, a preference that continued at 1-yr. follow-up.

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