A 30-month follow-up of generalized anxiety disorder: Status after metacognitive therapy and intolerance of uncertainty-therapy

2014 ◽  
Vol 2 (4) ◽  
pp. 434 ◽  
Author(s):  
Colin Van der Heiden ◽  
Kim Melchior
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Controlled Trial ◽  
Intolerance Of Uncertainty ◽  
Generalized Anxiety ◽  
Metacognitive Therapy ◽  
Delayed Treatment ◽  
Sustained Efficacy

Objectives: Although metacognitive therapy and intolerance-of-uncertainty therapy are considered efficacious treatments for generalized anxiety disorder, little is known about the long-term course in patients who engaged in treatment studies. Method: We conducted a continuation study of patients with GAD who had participated in a randomized, delayed treatment controlled trial in which the relative efficacy of MCT and IUT were compared.Results: Of the original 85 patients who completed the study, 34 were available for assessment of worry severity at 30-month follow-up. Both treatment groups showed maintenance of treatment gains from 6-month to 30-month follow-up assesment. However, MCT produced better results at long-term follow-up, which was reflected in statistically and clinically significant differences, and in terms of sustained efficacy (i.e., the degree in which patients who improved with treatment remained improved).Conclusion: Both MCT and IUT may be associated with long-term benefits for patients diagnosed with GAD, with MCT performing significantly better than IUT, and showing greater sustained efficacy.

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.

Switching from long-term benzodiazepine therapy to pregabalin in patients with generalized anxiety disorder: a double-blind, placebo-controlled trial

2011 ◽  
Vol 26 (4) ◽  
pp. 461-470 ◽  
Author(s):  
Sallie J Hadley ◽  
Francine S Mandel ◽  
Edward Schweizer
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Rating Scale ◽  
Controlled Trial ◽  
Generalized Anxiety ◽  
Double Blind Study ◽  
Double Blind ◽  
Significant Difference ◽  
Hamilton Anxiety Rating Scale

To evaluate the efficacy of pregabalin in facilitating taper off chronic benzodiazepines, outpatients ( N = 106) with a lifetime diagnosis of generalized anxiety disorder (current diagnosis could be subthreshold) who had been treated with a benzodiazepine for 8–52 weeks were stabilized for 2–4 weeks on alprazolam in the range of 1–4 mg/day. Patients were then randomized to 12 weeks of double-blind treatment with either pregabalin 300–600 mg/day or placebo while undergoing a gradual benzodiazepine taper at a rate of 25% per week, followed by a 6-week benzodiazepine-free phase during which they continued double-blind study treatment. Outcome measures included ability to remain benzodiazepine-free (primary) as well as changes in Hamilton Anxiety Rating Scale (HAM)-A and Physician Withdrawal Checklist (PWC). At endpoint, a non-significant higher proportion of patients remained benzodiazepine-free receiving pregabalin compared with placebo (51.4% vs 37.0%). Treatment with pregabalin was associated with significantly greater endpoint reduction in the HAM-A total score versus placebo (−2.5 vs +1.3; p < 0.001), and lower endpoint mean PWC scores (6.5 vs 10.3; p = 0.012). Thirty patients (53%) in the pregabalin group and 19 patients (37%) in the placebo group completed the study, reducing the power to detect a significant difference on the primary outcome. The results on the anxiety and withdrawal severity measures suggest that switching to pregabalin may be a safe and effective method for discontinuing long-term benzodiazepine therapy.

Long-term follow-up of generalized anxiety disorder

1993 ◽  
Vol 34 (6) ◽  
pp. 441-446 ◽  
Author(s):  
Donna M. Mancuso ◽  
Mark H. Townsend ◽  
Donald E. Mercante
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Generalized Anxiety ◽  
Long Term Follow Up

Group cognitive-behavioral therapy for generalized anxiety disorder: Treatment outcome and long-term follow-up.

2003 ◽  
Vol 71 (4) ◽  
pp. 821-825 ◽  
Author(s):  
Michel J. Dugas ◽  
Robert Ladouceur ◽  
Eliane Léger ◽  
Mark H. Freeston ◽  
Frédéric Langolis ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Anxiety Disorder ◽  
Cognitive Behavioral Therapy ◽  
Generalized Anxiety Disorder ◽  
Behavioral Therapy ◽  
Generalized Anxiety ◽  
Long Term Follow Up ◽  
Disorder Treatment

Positive Emotion in Generalized Anxiety Disorder

2019 ◽  
pp. 297-311
Author(s):  
Ilana Seager ◽  
Douglas S. Mennin ◽  
Amelia Aldao
Keyword(s):  
Anxiety Disorder ◽  
Positive Affect ◽  
Generalized Anxiety Disorder ◽  
Positive Emotion ◽  
Behavioral Therapy ◽  
Generalized Anxiety ◽  
Emotional Dysfunction ◽  
Wide Range ◽  
Future Work

Generalized anxiety disorder (GAD) is a debilitating condition characterized by excessive, pervasive, uncontrollable, and paralyzing worries about a wide range of future situations. Individuals with this condition frequently find themselves stuck in worry and tension cycles in futile attempts at reducing uncertainty and increasing control. GAD has been associated with substantial impairments in functioning and reduced quality of life. GAD remains poorly understood, and the long-term efficacy and end-state functioning resulting from treatment are weaker compared to other anxiety disorders. Some treatments (e.g., emotion regulation therapy, acceptance-based behavioral therapy) have improved efficacy, partly by targeting emotional dysfunction. Basic psychopathology research has focused on identifying the role of negative affect in GAD, so little is known about how positive affect is experienced and regulated in this disorder. This is particularly important in light of the overlap of this condition with major depressive disorder, which is characterized by low or suppressed positive emotion. Developing such an understanding is essential to further improve the efficacy of emotion-based treatments. This chapter reviews current and future directions in the study of positive affect in GAD. The chapter reviews the nascent research on positive affect and GAD, then illustrates dimensions of future work.

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