Is it Beneficial to Add Pharmacotherapy to Cognitive-Behavioral Therapy when Treating Anxiety Disorders? A Meta-Analytic Review.
Is it Beneficial to Add Pharmacotherapy to Cognitive-Behavioral Therapy when Treating Anxiety Disorders? A Meta-Analytic Review.
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DOI：
10.1521/ijct.2009.2.2.160
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发表时间：
2009-01-01
影响因子：
2.6
通讯作者：
Smits JA
中科院分区：
文献类型：
--
作者：
Hofmann SG;Sawyer AT;Korte KJ;Smits JA
为了检验在认知行为疗法（CBT）基础上增加药物治疗对焦虑症的益处，我们检索了在第一年至2008年7月1日期间，对符合DSM-III-R或DSM-IV诊断标准的焦虑症成人进行CBT加药物治疗和CBT加安慰剂的研究。在最初考虑的874项研究中，确定了11项研究，代表471例有急性后完成者数据的患者和236例有随访完成者数据的受试者。在治疗后，CBT+药物治疗通常比CBT+安慰剂更有效，用于测量焦虑症严重程度（Hedges' g = 0.59，95%置信区间：0.29-0.90）和治疗反应（OR：1.95，95%置信区间：1.25-3.03），但在6个月随访时并非如此。尽管研究数量相对较少，但故障安全N表明结果是可靠的。治疗后的最大效应量被发现用于惊恐障碍和广泛性焦虑障碍。自我报告和临床医生管理的措施之间没有差异。报告的效应量随出版年份线性下降。总之，有初步证据表明，在CBT中加入药物治疗至少对某些焦虑症是一种有用的短期治疗策略。
In order to examine the benefit of adding pharmacotherapy to cognitive-behavioral therapy (CBT) for anxiety disorders, we searched for studies comparing CBT plus pharmacotherapy and CBT plus pill placebo for adults meeting DSM-III-R or DSM-IV diagnostic criteria for an anxiety disorder between the 1st available year and July 1, 2008. Of 874 studies that were initially considered, 11 studies were identified, representing 471 patients with post-acute completer data and 236 participants with follow-up completer data. CBT plus pharmacotherapy was generally more effective than CBT plus placebo at post-treatment for measures of anxiety disorder severity (Hedges’ g = 0.59, 95% confidence interval: 0.29–0.90) and treatment response (OR: 1.95, 95% confidence interval: 1.25–3.03), but not at 6-month follow-up. Despite the relatively small number of studies, the fail-safe N suggested that the results are reliable. The largest effect sizes at post-treatment were found for panic disorder and generalized anxiety disorder. No differences were observed between self-report and clinician-administered measures. The reported effect sizes linearly decreased with publication year. In sum, there is preliminary evidence to suggest that adding pharmacotherapy to CBT is a useful short-term treatment strategy at least for some of the anxiety disorders.
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影响因子：
10.5
作者：
Hohagen, F;Winkelmann, G;Berger, M
通讯作者：
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