Srijana Shrestha1, Melinda A Stanley1, Nancy L Wilson1, Jeffrey A Cully1, Mark E Kunik1, Diane M Novy2, Howard M Rhoades3, Amber B Amspoker1. 1. VA HSR&D Houston Center for Innovations in Quality,Effectiveness and Safety,Michael E. DeBakey VA Medical Center,(MEDVAMC 152),2002 Holcombe Blvd., Houston,TX 77030,USA. 2. Department of Anesthesiology and Pain Medicine,The University of Texas M.D. Anderson Cancer Center,1515 Holcombe Blvd.,Unit 409,Houston,TX 77030,USA. 3. Harris County Psychiatric Center,The University of Texas Health Sciences Center,P.O. Box 20249,Houston,TX 77225,USA.
Abstract
BACKGROUND:Quality of life (QOL) is lower in older adults with generalized anxiety disorder (GAD). QOL generally improves following cognitive-behavioral treatment for GAD. Little is known, however, about additional variables predicting changes in QOL in older adults with GAD. This study examined predictors of change in QOL among older participants in a randomized clinical trial of cognitive behavioral therapy (CBT) for GAD, relative to enhanced usual care (EUC). METHODS: Hierarchical multilevel mixed-model analyses were used to examine inter-individual and intra-individual factors that predicted QOL over time. Predictors were categorized into treatment, personal and clinical characteristics. RESULTS:QOL improved over time, and there was significant variability between participants in change in QOL. Controlling for treatment condition, baseline general self-efficacy, baseline social support, within-person variation in worry and depression and average levels of depression across different time points predicted changes in QOL. CONCLUSIONS:QOL has increasingly been used as an outcome measure in treatment outcome studies to focus on overall improvement in functioning. Attention to improvement in symptoms of depression and worry, along with psychosocial variables, such as social support and self-efficacy, may help improve QOL in older adults with GAD. This study was a secondary study of data from a randomized clinical trial (NCT00308724) registered with clinical.trials.gov.
RCT Entities:
BACKGROUND: Quality of life (QOL) is lower in older adults with generalized anxiety disorder (GAD). QOL generally improves following cognitive-behavioral treatment for GAD. Little is known, however, about additional variables predicting changes in QOL in older adults with GAD. This study examined predictors of change in QOL among older participants in a randomized clinical trial of cognitive behavioral therapy (CBT) for GAD, relative to enhanced usual care (EUC). METHODS: Hierarchical multilevel mixed-model analyses were used to examine inter-individual and intra-individual factors that predicted QOL over time. Predictors were categorized into treatment, personal and clinical characteristics. RESULTS: QOL improved over time, and there was significant variability between participants in change in QOL. Controlling for treatment condition, baseline general self-efficacy, baseline social support, within-person variation in worry and depression and average levels of depression across different time points predicted changes in QOL. CONCLUSIONS: QOL has increasingly been used as an outcome measure in treatment outcome studies to focus on overall improvement in functioning. Attention to improvement in symptoms of depression and worry, along with psychosocial variables, such as social support and self-efficacy, may help improve QOL in older adults with GAD. This study was a secondary study of data from a randomized clinical trial (NCT00308724) registered with clinical.trials.gov.
Entities:
Keywords:
generalized anxiety disorder; older adults; predictors; quality of life
Authors: Hans-Ulrich Wittchen; Ron C Kessler; Katja Beesdo; Petra Krause; Michael Höfler; Jürgen Hoyer Journal: J Clin Psychiatry Date: 2002 Impact factor: 4.384