Department of Clinical Psychology, Johannes Gutenberg University Mainz, Germany.
Clin Psychol Rev. 2013 Dec;33(8):954-64. doi: 10.1016/j.cpr.2013.07.003. Epub 2013 Jul 20.
The primary aim of this study was to assess the overall effectiveness of individual and group outpatient cognitive behavioral therapy (CBT) for adults with a primary anxiety disorder in routine clinical practice.
We conducted a random effects meta-analysis of 71 nonrandomized effectiveness studies on outpatient individual and group CBT for adult anxiety disorders. Standardized mean gain effect sizes pre- to posttreatment, and posttreatment to follow-up are reported for disorder-specific symptoms, depression, and general anxiety. The mean dropout from CBT is reported.
Outpatient CBT was effective in reducing disorder-specific symptoms in completer (d=0.90-1.91) and intention-to-treat samples (d=0.67-1.45). Moderate to large (d=0.54-1.09) and small to large effect sizes (d=0.42-0.97) were found for depressive and general anxiety symptoms posttreatment. Across all anxiety disorders, the weighted mean dropout rate was 15.06%. Posttreatment gains for disorder-specific anxiety were maintained 12months after completion of therapy.
CBT for adult anxiety disorders is very effective and widely accepted in routine practice settings. However, the methodological and reporting quality of nonrandomized effectiveness studies must be improved.
本研究的主要目的是评估个体和团体门诊认知行为疗法（CBT）对成人原发性焦虑障碍的整体有效性。
我们对 71 项非随机有效性研究进行了随机效应荟萃分析，这些研究涉及成人焦虑障碍的个体和团体门诊 CBT。报告了从治疗前到治疗后，以及从治疗后到随访的特定障碍症状、抑郁和一般焦虑的标准化均数增益效应大小。还报告了 CBT 的平均辍学率。
门诊 CBT 在完成治疗者（d=0.90-1.91）和意向治疗样本（d=0.67-1.45）中有效降低了特定障碍的症状。治疗后，抑郁和一般焦虑症状的中等至大（d=0.54-1.09）和小至大（d=0.42-0.97）的效应大小。所有焦虑障碍的加权平均辍学率为 15.06%。完成治疗后 12 个月，特定焦虑障碍的治疗后获益得以维持。
成人焦虑障碍的 CBT 在常规实践环境中非常有效且被广泛接受。然而，非随机有效性研究的方法和报告质量必须得到提高。
