Treating Late-Life Generalized Anxiety Disorder in Primary Care An Effectiveness Pilot Study
Treating Late-Life Generalized Anxiety Disorder in Primary Care An Effectiveness Pilot Study
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DOI：
10.1097/nmd.0b013e31828e0fd6
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发表时间：
2013-05-01
影响因子：
1.9
通讯作者：
Stanley, Melinda A.
中科院分区：
文献类型：
--
作者：
Calleo, Jessica S.;Bush, Amber L.;Stanley, Melinda A.
为了提高认知行为疗法（CBT）在晚年焦虑初级保健中的可持续性，我们纳入了非专家咨询师、电话会议选项以及与初级保健临床医生的整合。这项开放试验检验了由经验丰富和无经验的咨询师为患有广泛性焦虑症 (GAD) 的老年人提供 CBT 的可行性、满意度和临床结果。临床结果评估了忧虑（宾夕法尼亚州立大学忧虑问卷）、GAD（广泛性焦虑症严重程度量表）和焦虑（贝克焦虑量表和汉密尔顿焦虑量表结构化访谈指南）。治疗 3 个月后，Cohen 对担心和焦虑的 d 效应值范围为 0.48 至 0.78。经过经验丰富和没有经验的咨询师治疗的患者的担忧和焦虑都有类似的减少，尽管经验丰富的治疗师的贝克焦虑量表的治疗结果有更大的改善。初步结果表明，适应的 CBT 可以有效减少担忧。试点的修改可以提供可接受且可行的循证护理。
To increase the sustainability of cognitive behavior therapy (CBT) in primary care for late-life anxiety, we incorporated nonexpert counselors, options for telephone meetings, and integration with primary care clinicians. This open trial examines the feasibility, satisfaction, and clinical outcomes of CBT delivered by experienced and nonexperienced counselors for older adults with generalized anxiety disorder (GAD). Clinical outcomes assessed worry (Penn State Worry Questionnaire), GAD (Generalized Anxiety Disorder Severity Scale), and anxiety (Beck Anxiety Inventory and Structured Interview Guide for Hamilton Anxiety Scale). After 3 months of treatment, Cohen's d effect sizes for worry and anxiety ranged from 0.48 to 0.78. Patients treated by experienced and nonexperienced counselors had similar reductions in worry and anxiety, although treatment outcomes were more improved on the Beck Anxiety Inventory for experienced therapists. Preliminary results suggest that adapted CBT can effectively reduce worry. The piloted modifications can provide acceptable and feasible evidence-based care.