Power K G, Simpson R J, Swanson V, Wallace L A
Department of Psychology, University of Stirling.
Br J Gen Pract. 1990 Jul;40(336):289-94.
A sample of 101 patients with generalized anxiety disorder were randomly allocated to one of five groups--diazepam, placebo, cognitive-behaviour therapy, diazepam plus cognitive-behaviour therapy, or placebo plus cognitive-behaviour therapy--and treated over 10 weeks in a primary care setting. All groups received a similar amount of contact with the psychologist and general practitioner. The greatest improvement in ratings of severity of symptoms and overall change in symptoms occurred with cognitive-behaviour therapy combined with diazepam; cognitive-behaviour therapy alone also performed well and cognitive-behaviour therapy plus placebo performed slightly less well. Diazepam alone showed improvement relative to placebo alone. There was a high level of agreement between ratings by the general practitioners, psychologist, and the patients of the response to treatment. At six months follow-up there was no difference between treatment groups in the proportion of patients receiving psychotropic medication after the end of the study. However, cognitive-behaviour therapy, either alone or in combination with drug or placebo, showed the lowest incidence of referral for psychological or psychiatric treatment at six months follow-up.
101名广泛性焦虑症患者被随机分配到五组之一——地西泮组、安慰剂组、认知行为疗法组、地西泮加认知行为疗法组或安慰剂加认知行为疗法组，并在初级保健机构接受为期10周的治疗。所有组与心理学家和全科医生的接触量相似。症状严重程度评分和症状总体变化方面改善最大的是认知行为疗法联合地西泮；单独的认知行为疗法效果也很好，认知行为疗法加安慰剂的效果稍差。单独使用地西泮相对于单独使用安慰剂有改善。全科医生、心理学家和患者对治疗反应的评分之间有高度一致性。在六个月的随访中，研究结束后接受精神药物治疗的患者比例在治疗组之间没有差异。然而，在六个月的随访中，认知行为疗法，无论是单独使用还是与药物或安慰剂联合使用，转介接受心理或精神治疗的发生率最低。
