Freshour Jessica S, Amspoker Amber B, Yi Misung, Kunik Mark E, Wilson Nancy, Kraus-Schuman Cynthia, Cully Jeffrey A, Teng Ellen, Williams Susan, Masozera Nicholas, Horsfield Matthew, Stanley Melinda
Michael E. DeBakey VA Medical Center, Houston, TX, USA.
Baylor College of Medicine, Houston, TX, USA.
Int J Geriatr Psychiatry. 2016 Nov;31(11):1225-1232. doi: 10.1002/gps.4431. Epub 2016 Feb 28.
Peaceful Living, a cognitive-behavioral treatment (CBT) for late-life generalized anxiety disorder (GAD), produced positive outcomes in GAD severity, anxiety, depression, insomnia, and mental health quality of life relative to usual care with treatment delivered by either bachelor-level lay providers (BLPs) or PhD-level expert providers (PLPs). We examined long-term maintenance of gains during 12 months following CBT for patients in this trial who received the intervention delivered by BLPs and PLPs and completed post-treatment assessments.
Participants were 112 older adults (mean age, 66.83 years) with GAD recruited from primary care who received CBT from BLPs (n = 52) or PLPs (n = 60) and completed post-treatment assessments. Assessments were given at post-treatment and at 6- and 12-month follow-up. Primary outcomes assessed long-term maintenance of gains in worry (Generalized Anxiety Disorder Severity Scale) and anxiety (State-Trait Anxiety Inventory, Structured Interview Guide for the Hamilton Anxiety Scale). Secondary outcomes assessed depression (Patient Health Questionnaire), mental health quality of life (Medical Outcomes Study Short Form - mental wellness scale), and sleep (Insomnia Severity Index).
At 6- and 12-month follow-ups, post-treatment reductions in GAD severity, anxiety, depression, and improvements in mental health quality of life and sleep were maintained for patients in both groups. No differences were found, based on provider group.
Treatment of late-life anxiety delivered by nonexpert lay providers working under supervision of licensed providers has lasting benefits. These findings support the potential of new models of care for older adults that may expand reach of mental health services. Copyright © 2016 John Wiley & Sons, Ltd.
“平和生活”是一种针对老年广泛性焦虑症（GAD）的认知行为疗法（CBT），与由本科水平的非专业提供者（BLP）或博士水平的专家提供者（PLP）提供的常规护理相比，在GAD严重程度、焦虑、抑郁、失眠和心理健康生活质量方面产生了积极的结果。我们对该试验中接受BLP和PLP提供的干预并完成治疗后评估的患者在CBT治疗后的12个月内进行了长期疗效维持情况的研究。
从初级保健机构招募了112名患有GAD的老年人（平均年龄66.83岁），他们接受了BLP（n = 52）或PLP（n = 60）提供的CBT治疗，并完成了治疗后评估。在治疗后、6个月和12个月随访时进行评估。主要结局评估了在担忧（广泛性焦虑症严重程度量表）和焦虑（状态-特质焦虑量表、汉密尔顿焦虑量表结构化访谈指南）方面的长期疗效维持情况。次要结局评估了抑郁（患者健康问卷）、心理健康生活质量（医学结局研究简表-心理健康量表）和睡眠（失眠严重程度指数）。
在6个月和12个月随访时，两组患者在治疗后GAD严重程度、焦虑、抑郁的降低以及心理健康生活质量和睡眠的改善均得以维持。基于提供者组未发现差异。
在有执照的提供者监督下，由非专业的非专家提供者提供的老年焦虑症治疗具有持久的益处。这些发现支持了可能扩大心理健康服务覆盖范围的老年人新型护理模式的潜力。版权所有© 2016约翰威立父子有限公司。
