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CBT improves worry severity in older adults with GAD in primary care

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Question

Question:

Does cognitive behavioural therapy (CBT) improve generalised anxiety disorder (GAD) in older adults in primary care?

Patients:

134 older adults (>60 years) with a principal or co-principal diagnosis of GAD (Structured Diagnostic Interview for DSM-IV). Exclusion criteria: current substance abuse, psychotic illness or bipolar disorder; and Mini-Mental State Examination score <24. Current antidepressant or anxiolytic use was not considered an exclusion criterion.

Setting:

Two primary care clinics, Texas, USA; March 2004–August 2006.

Intervention:

CBT or enhanced usual care (EUC). CBT involved manualised treatment from trained therapists delivered individually for up to 10 sessions over 12 weeks. It focused on cognitive therapy, behavioural therapy (eg, exposure), education and awareness, problem solving skills and sleep management. EUC involved usual care plus twice weekly phone calls by therapists during the first 3 months of the study.

Outcomes:

Primary outcomes: worry severity (self-report Penn State Worry Questionnaire (PSWQ)) and GAD severity (clinician rated Generalised Anxiety Disorder Severity Scale [GADSS]). Secondary outcomes: anxiety severity (Structured Interview Guide for the Hamilton Anxiety Scale); depression severity (Beck Depression Inventory II (BDI-II)); health related …

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