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Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial
Aimee Spector1, Georgina Charlesworth1, Michael King1
1Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
Background:
Anxiety is common and problematic in dementia, yet there is a lack of effective treatments.
Aims:
To develop a cognitive-behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.
Method:
A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months.
Results:
At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (-3.10, 95% CI -6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37, 95% CI -9.50 to -1.25). Improvements remained significant at 6 months. CBT was cost neutral.
Conclusions:
CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.
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