Caudle Donald D, Senior Ashley C, Wetherell Julie Loebach, Rhoades Howard M, Beck J G, Kunik Mark E, Snow A Lynn, Wilson Nancy L, Stanley Melinda A
Department of Educational Psychology, University of Houston, Houston, TX, USA.
Am J Geriatr Psychiatry. 2007 Aug;15(8):680-9. doi: 10.1097/JGP.0b013e31803c550d.
Recent research by Wetherell et al. investigating the differential response to group-administered cognitive behavior therapy (CBT) for generalized anxiety disorder (GAD) in older adults found that GAD severity, homework adherence, and psychiatric comorbidity predicted statistically significant improvement. The current study investigated whether the presence/absence of cognitive errors on separate domains of the Mini-Mental State Exam (MMSE) predicted baseline differences in symptom severity and improvement following CBT, above and beyond already established predictors.
Baseline characteristics were investigated in a sample of 208 older patients diagnosed with GAD. Predictors of treatment response were examined in a subsample of 65 patients who completed CBT and were included in a prior study by Wetherell et al. of response predictors.
Results from the baseline sample indicated that only subjects who committed an error on the MMSE Working Memory domain exhibited increased severity in anxiety and depressive symptoms. Results from the treatment sample indicated that an error on the MMSE Orientation domain was a significant predictor of outcome at 6-month follow-up, while controlling for previously established predictors. Patients who committed at least one error in this domain showed decreased response relative to patients who committed no errors.
In this sample of older adults diagnosed with GAD, poor performance on the MMSE Working Memory domain was associated with increased baseline anxiety and depression, while baseline performance differences on the MMSE Orientation domain predicted outcome six months after CBT intervention.
韦瑟雷尔等人最近的研究调查了老年人对团体认知行为疗法（CBT）治疗广泛性焦虑症（GAD）的不同反应，发现广泛性焦虑症严重程度、家庭作业依从性和精神共病在统计学上可预测显著改善。本研究调查了简易精神状态检查表（MMSE）各独立领域认知错误的有无是否能预测CBT治疗前后症状严重程度的基线差异以及改善情况，且超出已确定的预测因素。
对208名被诊断为广泛性焦虑症的老年患者样本进行基线特征调查。在65名完成CBT治疗的患者子样本中检查治疗反应的预测因素，这些患者被纳入韦瑟雷尔等人之前关于反应预测因素的研究。
基线样本结果表明，只有在MMSE工作记忆领域出现错误的受试者焦虑和抑郁症状严重程度增加。治疗样本结果表明，在控制先前确定的预测因素的情况下，MMSE定向领域的错误是6个月随访结果的显著预测因素。在该领域至少出现一个错误的患者相对于未出现错误的患者反应降低。
在这个被诊断为广泛性焦虑症的老年患者样本中，MMSE工作记忆领域表现不佳与基线焦虑和抑郁增加有关，而MMSE定向领域的基线表现差异可预测CBT干预6个月后的结果。
