Augmenting antidepressant medication with modular CBT for geriatric generalized anxiety disorder: a pilot study

International Journal of Geriatric Psychiatry - Tập 26 Số 8 - Trang 869-875 - 2011
Julie Loebach Wetherell1,2, Jill A. Stoddard3, Kamila S. White4, Sander J. Kornblith5, Hoang M. Nguyen1,2, Carmen Andreescu5, Sidney Zisook1,2, Eric J. Lenze6
1Department of Psychiatry, University of California San Diego, La Jolla, California, USA
2VA San Diego Healthcare System San Diego California USA
3Department of Psychology, Alliant International University, San Diego, California, USA
4Department of Psychology , University of Missouri , St. Louis , Missouri , USA
5Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
6Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri USA

Tóm tắt

AbstractObjective

Generalized anxiety disorder (GAD) is a prevalent psychiatric condition in older adults with deleterious effects on health and cognition. Although selective serotonin reuptake inhibitor (SSRI) medications have some efficacy as acute treatments for geriatric GAD, incomplete response is the most common outcome of monotherapy. We therefore developed a novel sequential treatment strategy, using personalized, modular cognitive‐behavioral therapy (mCBT) to augment SSRI medication.

Method

In an open label pilot study (N = 10), subjects received a sequenced trial of 12 weeks of escitalopram followed by 16 weeks of escitalopram augmented with mCBT. We also examined the maintenance effects of mCBT over a 28‐week follow‐up period following drug discontinuation and termination of psychotherapy.

Results

Results suggest that (1) adding mCBT to escitalopram significantly reduced anxiety symptoms and pathological worry, resulting in full remission for most patients and (2) some patients maintained response after all treatments were withdrawn.

Conclusion

Findings suggest that mCBT may be an effective augmentation strategy when added to SSRI medication and provide limited support for the long‐term benefit of mCBT after discontinuation of pharmacotherapy. Copyright © 2010 John Wiley & Sons, Ltd.

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Tài liệu tham khảo

10.1017/S1461145705005973

10.1007/s00213-007-1004-8

Association AP, 2000, Diagnostic and Statistical Manual for Mental Disorders

10.1002/(SICI)1099-1166(1998100)13:10<717::AID-GPS857>3.0.CO;2-M

10.1017/S0033291797005734

10.1097/JGP.0b013e31815aff5c

10.1192/bjp.171.4.328

10.4088/JCP.v67n0319

10.1037/0022-006X.73.4.647

10.1016/j.cpr.2005.07.003

10.1097/JGP.0b013e31818f3a93

10.1017/S0033291799008351

10.1023/A:1010967725849

10.1586/14737175.6.11.1735

10.4088/JCP.v66n1108

First MB, 1996, Structured Clinical Interview for DSM‐IV Axis I Disorders (SCID), Clinician Version: Administration Booklet

10.1016/0022-3956(75)90026-6

10.1111/j.1532-5415.2005.00571.x

10.1097/JGP.0b013e3181ad4f5a

10.1111/j.2044-8341.1959.tb00467.x

10.1521/ijct.2009.2.2.160

10.1001/archpsyc.62.4.417

10.1016/S0033-3182(82)73363-8

10.1097/00019442-200501000-00005

10.1097/00019442-200501000-00011

10.1001/jama.2008.977

10.1002/gps.2074

10.1037/0022-006X.72.1.31

10.1016/j.psyneuen.2008.03.002

10.1037/a0018121

10.1016/j.cpr.2007.01.003

10.1016/0005-7967(90)90135-6

10.1016/0165-1781(92)90005-N

10.2165/00002512-200825010-00007

10.1097/00006842-199901000-00013

10.1017/S003329170400282X

10.1097/JGP.0b013e31819b87b2

10.1111/j.1600-0447.2006.00896.x

10.1002/gps.1001

10.1097/01.JGP.0000196629.19634.00

10.1017/S1041610209990536

10.1002/gps.1004

Stanley MA, 2009, Cognitive behavior therapy for generalized anxiety disorder among older adults in primary care: a randomized clinical trial, JAMA, 301, 1460, 10.1001/jama.2009.458

10.1097/JGP.0b013e3180590ba9

10.1001/jama.288.22.2836

10.1097/JGP.0b013e3181a31fb5

10.1111/j.1600-0447.2005.00531.x

10.1002/gps.2076

10.1111/j.1532-5415.2008.02127.x

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Thông tin xuất bản

International Journal of Geriatric Psychiatry

Tập 26 Số 8

869-875

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