scholarly journals Digital Interventions for Generalized Anxiety Disorder (GAD): Systematic Review and Network Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Pedro Saramago ◽  
Lina Gega ◽  
David Marshall ◽  
Georgios F. Nikolaidis ◽  
Dina Jankovic ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Meta Analysis ◽  
Antidepressant Medication ◽  
Generalized Anxiety ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Self Help ◽  
Digital Interventions ◽  
Better Than

Background: Generalized anxiety disorder is the most common mental health condition based on weekly prevalence. Digital interventions have been used as alternatives or as supplements to conventional therapies to improve access, patient choice, and clinical outcomes. Little is known about their comparative effectiveness for generalized anxiety disorder.Methods: We conducted a systematic review and network meta-analysis of randomized controlled trials comparing digital interventions with medication, non-digital interventions, non-therapeutic controls, and no intervention.Results: We included 21 randomized controlled trials with a total of 2,350 participants from generalized anxiety disorder populations. Pooled outcomes using analysis of Covariance and rankograms based on the surface under the cumulative ranking curves indicated that antidepressant medication and group therapy had a higher probability than digital interventions of being the “best” intervention. Supported digital interventions were not necessarily “better” than unsupported (pure self-help) ones.Conclusions: Due to very wide confidence intervals, network meta-analysis results were inconclusive as to whether digital interventions are better than no intervention and non-therapeutic active controls, or whether they confer an additional benefit to standard therapy. Future research needs to compare digital interventions with one-to-one therapy and with manualized non-digital self-help and to include antidepressant medication as a treatment comparator and effect modifier.

Digital interventions for generalised anxiety disorder (GAD): systematic review and network meta-analysis (Preprint)

2020 ◽  
Author(s):  
Pedro Saramago ◽  
Lina Gega ◽  
David Marshall ◽  
Georgios Nikolaidis ◽  
Dina Jankovic ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anxiety Disorder ◽  
Meta Analysis ◽  
Antidepressant Medication ◽  
Patient Choice ◽  
Analysis Of Covariance ◽  
Generalised Anxiety Disorder ◽  
Self Help ◽  
Digital Interventions ◽  
Better Than

UNSTRUCTURED Generalised anxiety disorder (GAD) is the most common mental health condition based on weekly prevalence. Digital interventions (DIs) have been used as alternatives or as add-ons to conventional therapies to improve access, patient choice and clinical outcomes. Little is known about their comparative effectiveness for GAD. To address this, we conducted a systematic review and network meta-analysis (NMA) of randomised controlled trials (RCTs) comparing DIs with medication, non-digital interventions, non-therapeutic controls and no intervention. We included 21 RCTs with a total of 2,350 participants from GAD populations. Pooled outcomes using analysis of Covariance and rankograms based on the surface under the cumulative ranking curves (SUCRA) indicated that antidepressant medication and group therapy had a higher probability than DIs of being the ‘best’ intervention. Supported DIs were not necessarily “better” than unsupported (pure self-help) ones. Due to very wide confidence intervals, NMA results were inconclusive as to whether DIs are better than no intervention and non-therapeutic active controls, or whether they confer an additional benefit to standard therapy. Future research needs to compare DIs with one-to-one therapy and with manualised non-digital self-help and to include antidepressant medication as a treatment comparator and effect modifier.

scholarly journals A randomized controlled feasibility trial of internet-delivered guided self-help for generalized anxiety disorder (GAD) among university students in India.

Psychotherapy ◽  
2021 ◽  
Vol 58 (4) ◽  
pp. 591-601
Author(s):  
Michelle G. Newman ◽  
Nitya Kanuri ◽  
Gavin N. Rackoff ◽  
Nicholas C. Jacobson ◽  
Megan Jones Bell ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
University Students ◽  
Generalized Anxiety Disorder ◽  
Feasibility Trial ◽  
Generalized Anxiety ◽  
Randomized Controlled ◽  
Self Help

scholarly journals Self-help guided by trained lay providers for generalized anxiety disorder in older adults: study protocol for a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Philippe Landreville ◽  
Patrick Gosselin ◽  
Sébastien Grenier ◽  
Pierre-Hugues Carmichael
Keyword(s):  
Older Adults ◽  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Controlled Trial ◽  
Post Treatment ◽  
Control Group ◽  
Generalized Anxiety ◽  
Randomized Controlled ◽  
Self Help ◽  
Experimental Group

Abstract Background Only a small proportion of older patients with generalized anxiety disorder (GAD) seek professional help. Difficulties in accessing treatment may contribute to this problem. Guided self-help based on the principles of cognitive-behavioral therapy (GSH-CBT) is one way of promoting access to psychological treatment. Moreover, because the therapist’s role in GSH-CBT is limited to supporting the patient, this role could be assumed by trained and supervised lay providers (LPs) instead of licensed providers. The main goal of this study is to evaluate the efficacy of GSH-CBT guided by LPs for primary threshold or subthreshold GAD in older adults. Methods We will conduct a multisite randomized controlled trial comparing an experimental group receiving GSH-CBT guided by LPs (n = 45) to a wait-list control group (n = 45). Treatment will last 15 weeks and will be based on a participant’s manual. Weekly telephone sessions with LPs (30 min maximum) will be limited to providing support. Data will be obtained through clinician evaluations and self-assessment questionnaires. Primary outcomes will be the tendency to worry and severity of GAD symptoms. Secondary outcomes will be anxiety symptoms, sleep difficulties, functional deficit, diagnosis of GAD, and cognitive difficulties. For the experimental group, measurements will take place at pre- and post-treatment and at 6 and 12 months post-treatment. For the control group, three evaluations are planned: two pre-treatment evaluations (before and after the waiting period) and after receiving treatment (post-treatment). The efficacy of GSH-CBT will be established by comparing the change in the two groups on the primary outcomes. Discussion This project will provide evidence on the efficacy of a novel approach to treat GAD in older adults. If effective, it could be implemented on a larger scale and provide many older adults with much needed mental health treatment through an expanded workforce. Trial registration The trial was registered at ClinicalTrials.gov, number NCT03768544, on December 7, 2018.

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