在初级保健中,针对老年人普遍焦虑症的认知行为疗法:一项随机临床试验
Melinda A Stanley1, Nancy L Wilson, Diane M Novy
1Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, and Houston Center for Quality of Care & Utilization Studies, Houston, TX 77030, USA. mstanley@bcm.tmc.edu
JAMA
|April 9, 2009
概括
认知行为疗法 (CBT) 在初级保健中显著改善了老年人普遍焦虑障碍 (GAD) 的焦虑和抑郁症状. 然而,与增强的常规护理相比,CBT并没有显著改善GAD严重程度.
科学领域:
- 老年精神病学是一门精神病学专业.
- 初级医疗保健医学 一级医疗保健医学
- 行为治疗是一种行为疗法.
背景情况:
- 一般性焦虑障碍 (GAD) 在寻求初级保健的老年人中很普遍.
- 试点研究表明认知行为疗法 (CBT) 对晚年GAD的疗效.
- 关于CBT在这种人口群体的初级保健环境中的有效性,研究有限.
研究的目的:
- 为了评估CBT的疗效与GAD诊断的老年人的增强常规护理 (EUC) 相比.
- 评估CBT对焦虑,焦虑,抑郁症状和初级保健机构生活质量的影响.
主要方法:
- 一项随机临床试验涉及134名患有GAD的老年人 (平均年龄66.9岁).
- 参与者接受了3个月的CBT或EUC,后续评估长达15个月.
- 测量的主要结果是焦虑严重程度和GAD严重程度,次要结果包括焦虑,抑郁和生活质量.
主要成果:
- 与EUC相比,CBT显著降低了焦虑严重程度 (P < .001) 和抑郁症状 (P = .02).
- 在CBT组中,一般心理健康也显著改善 (P = .008).
- 在CBT和EUC组之间没有观察到GAD严重程度 (P = .19) 的显著差异,尽管CBT对焦虑的反应率更高.
结论:
- 在初级保健中,CBT对GAD的老年人显著有好处,特别是在减少焦虑和抑郁症状方面.
- 虽然CBT改善了整体心理健康,但其对整体GAD严重程度的影响需要进一步调查.
- 这些发现支持将CBT整合到初级保健中,以管理老年人群中的焦虑.
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