Literature DB >> 22283717

Efficacy of cognitive behavioral therapy for anxiety disorders in older people: a meta-analysis and meta-regression of randomized controlled trials.

Rebecca L Gould1, Mark C Coulson, Robert J Howard.   

Abstract

OBJECTIVES: To review the magnitude and duration of and factors associated with effects of cognitive behavioral therapy (CBT) for anxiety disorders in older people.
DESIGN: Electronic literature databases and the Cochrane Trials Registry were searched for articles. A systematic critical review, random-effects meta-analysis, and meta-regression of randomized controlled trials were conducted.
SETTING: Community outpatient clinics. PARTICIPANTS: People with diagnoses of anxiety disorders. MEASUREMENTS: Outcome measures of anxiety and depression.
RESULTS: Twelve studies were included. CBT was significantly more effective than treatment as usual or being on a waiting list at reducing anxiety symptoms at 0-month follow-up, with the effect size being moderate, but when CBT was compared with an active control condition, the between-group difference in favor of CBT was not statistically significant, and the effect size was small. At 6- but not 3- or 12-month follow-up, CBT was significantly more effective at reducing anxiety symptoms than an active control condition, although the effect size was again small. Meta-regression analyses revealed only one factor (type of control group) to be significantly associated with the magnitude of effect sizes.
CONCLUSION: The review confirms the effectiveness of CBT for anxiety disorders in older people but is suggestive of lower efficacy in older than working-age people. The small effect sizes in favor of CBT over an active control condition illustrate the need to investigate other treatment approaches that may be used to substitute or augment CBT to increase the effectiveness of treatment of anxiety disorders in older people.
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

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Mesh:

Year:  2012        PMID: 22283717     DOI: 10.1111/j.1532-5415.2011.03824.x

Source DB:  PubMed          Journal:  J Am Geriatr Soc        ISSN: 0002-8614            Impact factor:   5.562


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3.  No End in Sight: Benzodiazepine Use in Older Adults in the United States.

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4.  Non-pharmacological interventions for depression/anxiety in older adults with physical comorbidities affecting functioning: systematic review and meta-analysis.

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5.  Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults.

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6.  Age differences in treatment response to a collaborative care intervention for anxiety disorders.

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8.  Antidepressant medication augmented with cognitive-behavioral therapy for generalized anxiety disorder in older adults.

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Review 9.  Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders.

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10.  Cognitive-behavioral therapy augmentation of SSRI reduces cortisol levels in older adults with generalized anxiety disorder: A randomized clinical trial.

Authors:  Christopher B Rosnick; Julie L Wetherell; Kamila S White; Carmen Andreescu; David Dixon; Eric J Lenze
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