Long-term outcome of cognitive behaviour therapy clinical trials in central Scotland

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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S.05.03 Cognitive-behaviour therapy interventions in PRS: short-term and long-term outcomes

European Neuropsychopharmacology ◽

10.1016/s0924-977x(11)70255-3 ◽

2011 ◽

Vol 21 ◽

pp. S192

Author(s):

A. Bechdolf

Keyword(s):

Cognitive Behaviour Therapy ◽

Behaviour Therapy ◽

Long Term Outcomes ◽

Short Term ◽

Cognitive Behaviour ◽

Therapy Interventions

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Prediction of outcome in neurotic disorder: a 5-year prospective study

Psychological Medicine ◽

10.1017/s0033291798007119 ◽

1998 ◽

Vol 28 (5) ◽

pp. 1149-1157 ◽

Cited By ~ 54

Author(s):

H. SEIVEWRIGHT ◽

P. TYRER ◽

T. JOHNSON

Keyword(s):

Initial Response ◽

Favourable Outcome ◽

Dysthymic Disorder ◽

Response To Treatment ◽

Behaviour Therapy ◽

Neurotic Disorder ◽

Term Outcome ◽

Long Term Outcome ◽

Predicting Outcome

Background. There have been no previous studies of the outcome of different neurotic disorders in which a prospective group with original randomization to treatment have been followed up over a long period. Such studies are important in identifying the factors associated with good and poor outcome.Methods. A 5-year follow-up assessment was made of a cohort of 210 psychiatric out-patients seen in general practice psychiatric clinics with a DSM-III diagnosis of generalized anxiety disorder (71), panic disorder (74) or dysthymic disorder (65) and randomized to drug treatment, cognitive and behaviour therapy, and self-help. A total of 182 of the patients (87%) were assessed after 5 years by examination of hospital and GP records using a standardized procedure and outcome determined with a four-point outcome scale.Results. One hundred and seven (60%) of the patients had a favourable outcome but the remainder continued to be handicapped either intermittently or continuously throughout the 5-year period. Analysis of the value of initial data in predicting outcome using polychotomous step-wise logistic regression revealed that five variables were significant predictors of poor prognosis: older age; recurrent episodes; the presence of personality disorder at entry; general neurotic syndrome at entry; and symptom severity after 10 weeks. The initial DSM diagnosis and original treatment given, together with ten other variables, were of no predictive value.Conclusions. The long-term outcome of neurotic disorder is better predicted by age, personality and recency of onset than by other clinical variables with the exception of initial response to treatment.

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Web-based cognitive behaviour therapy for insomnia shows long-term efficacy in improving chronic insomnia

Evidence-Based Mental Health ◽

10.1136/eb-2017-102726 ◽

2017 ◽

Vol 21 (1) ◽

pp. e3-e3 ◽

Cited By ~ 2

Author(s):

Hailey Meaklim ◽

David Cunnington

Keyword(s):

Cognitive Behaviour Therapy ◽

Chronic Insomnia ◽

Behaviour Therapy ◽

Web Based ◽

Term Efficacy ◽

Cognitive Behaviour

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Baseline Heartbeat Perception Accuracy and Short-Term Outcome of Brief Cognitive-Behaviour Therapy for Panic Disorder with Agoraphobia

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246581300101x ◽

2013 ◽

Vol 43 (4) ◽

pp. 426-435 ◽

Cited By ~ 2

Author(s):

Vasilios G. Masdrakis ◽

Emilia-Maria Legaki ◽

Nikolaos Vaidakis ◽

Dimitrios Ploumpidis ◽

Constantin R. Soldatos ◽

...

Keyword(s):

Panic Disorder ◽

Cognitive Behaviour Therapy ◽

Acute Treatment ◽

Panic Attacks ◽

Behaviour Therapy ◽

Short Term ◽

Term Outcome ◽

Heartbeat Perception ◽

Short Term Outcome ◽

Cognitive Behaviour

Background: Increased heartbeat perception accuracy (HBP-accuracy) may contribute to the pathogenesis of Panic Disorder (PD) without or with Agoraphobia (PDA). Extant research suggests that HBP-accuracy is a rather stable individual characteristic, moreover predictive of worse long-term outcome in PD/PDA patients. However, it remains still unexplored whether HBP-accuracy adversely affects patients’ short-term outcome after structured cognitive behaviour therapy (CBT) for PD/PDA. Aim: To explore the potential association between HBP-accuracy and the short-term outcome of a structured brief-CBT for the acute treatment of PDA. Method: We assessed baseline HBP-accuracy using the “mental tracking” paradigm in 25 consecutive medication-free, CBT-naive PDA patients. Patients then underwent a structured, protocol-based, 8-session CBT by the same therapist. Outcome measures included the number of panic attacks during the past week, the Agoraphobic Cognitions Questionnaire (ACQ), and the Mobility Inventory-Alone subscale (MI-alone). Results: No association emerged between baseline HBP-accuracy and posttreatment changes concerning number of panic attacks. Moreover, higher baseline HBP-accuracy was associated with significantly larger reductions in the scores of the ACQ and the MI-alone scales. Conclusion: Our results suggest that in PDA patients undergoing structured brief-CBT for the acute treatment of their symptoms, higher baseline HBP-accuracy is not associated with worse short-term outcome concerning panic attacks. Furthermore, higher baseline HBP-accuracy may be associated with enhanced therapeutic gains in agoraphobic cognitions and behaviours.

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