Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
Br J Psychiatry. 2015 Jun;206(6):509-16. doi: 10.1192/bjp.bp.113.140087. Epub 2015 Feb 19.
Anxiety is common and problematic in dementia, yet there is a lack of effective treatments.
To develop a cognitive-behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.
A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months.
At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (-3.10, 95% CI -6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37, 95% CI -9.50 to -1.25). Improvements remained significant at 6 months. CBT was cost neutral.
CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.
焦虑在痴呆症中很常见且成问题，但目前缺乏有效的治疗方法。
制定一种针对痴呆症焦虑的认知行为疗法（CBT）手册，并通过随机对照试验确定其可行性。
制定了十节 CBT 手册。将患有痴呆症和焦虑症的患者（及其照顾者）随机分配至 CBT 加常规治疗（TAU）（n = 25）或 TAU（n = 25）组。在基线、15 周和 6 个月时进行了结局和成本测量。
在 15 周时，与 TAU 相比，CBT 组的焦虑（使用痴呆症焦虑量表评定）调整后差异为 (-3.10, 95% CI -6.55 至 0.34)，这一差异仅略微低于统计学意义。调整后，抑郁在 15 周时显著改善 (-5.37, 95% CI -9.50 至 -1.25)。6 个月时改善仍有统计学意义。CBT 在成本上是中性的。
CBT 是可行的（在招募、可接受性和脱落率方面）且有效的。现在需要进行一项充分有力的 RCT。
Zotero 插件