Pinquart Martin, Duberstein Paul R
Department of Developmental Psychology, Friedrich Schiller University, Jena, Germany.
Am J Geriatr Psychiatry. 2007 Aug;15(8):639-51. doi: 10.1097/JGP.0b013e31806841c8.
To reduce the morbidity attributable to anxiety disorders in old age and to improve the quality of care, data on the effectiveness of current treatments are needed.
A comparative meta-analysis of 32 studies of treatments focused on anxiety disorders in older adults (N = 2,484) receiving behavioral interventions or pharmacotherapy was conducted.
In separate analyses of the effects of interventions, stronger improvements of anxiety symptoms are found in pharmacotherapy than in behavioral interventions (d = 1.76 versus d = 0.81 SD units). This difference disappears when computing effect sizes that control for nonspecific change in the control group (d = 0.80 and d = 0.83 SD units) because effect sizes are greater in pill-placebo controls of pharmacological studies than in control groups (e.g., wait list) of behavioral interventions (d = 1.06 versus d = 0.10 SD units). Both interventions also yield moderate reductions in depressive symptoms (d = 0.59 versus d = 0.61 SD units), and dropout rates were comparable.
Available pharmacotherapy and behavioral interventions are reasonably effective. Given the higher average treatment effects of pharmacological interventions, pharmacotherapy may be the first choice of treatment as long as medical conditions and patients' preferences do not preclude this form of treatment.
为降低老年焦虑症的发病率并提高护理质量，需要有关当前治疗效果的数据。
对32项针对接受行为干预或药物治疗的老年焦虑症患者（N = 2484）的治疗研究进行了比较荟萃分析。
在对干预效果的单独分析中，发现药物治疗比行为干预对焦虑症状的改善更明显（效应量d = 1.76对d = 0.81标准差单位）。当计算控制对照组非特异性变化的效应量时，这种差异消失了（d = 0.80和d = 0.83标准差单位），因为药物研究的安慰剂对照组的效应量大于行为干预对照组（如等待名单）的效应量（d = 1.06对d = 0.10标准差单位）。两种干预措施对抑郁症状也都有中度减轻作用（d = 0.59对d = 0.61标准差单位），且脱落率相当。
现有的药物治疗和行为干预措施相当有效。鉴于药物干预的平均治疗效果更高，只要身体状况和患者偏好不排除这种治疗形式，药物治疗可能是首选治疗方法。
