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焦虑障碍的认知行为治疗:多州、多地点初级保健实践的结果。

Cognitive Behavioral Therapy for Anxiety Disorders: Outcomes From a Multi-State, Multi-Site Primary Care Practice.

机构信息

Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN, USA.

Division of Integrated Behavioral Health, Mayo Clinic, Rochester, MN, USA; Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA.

出版信息

J Anxiety Disord. 2021 Mar;78:102345. doi: 10.1016/j.janxdis.2020.102345. Epub 2020 Dec 15.

DOI:10.1016/j.janxdis.2020.102345
PMID:33395601
Abstract

BACKGROUND

Anxiety disorders are among the most common mental health conditions. Individuals with anxiety typically seek services in primary, rather than specialty, care. While there is significant evidence supporting the efficacy and effectiveness of cognitive behavioral therapy (CBT) for anxiety disorders, there have been no naturalistic studies reporting anxiety-specific treatment outcomes in primary care.

METHODS

Participants (N = 1,589) were recruited from a multi-state, multi-site primary care practice, with 491 participants endorsing moderate to severe anxiety at baseline and engaging in at least one CBT session. Data was drawn from a psychotherapy tracking database.

RESULTS

Among participants with moderate to severe anxiety who engaged in CBT, a significant decrease in anxiety and depression symptoms was observed over the course of psychotherapy (p< .001, d = 0.57-0.95). Rates of reliable change, response, and remission varied across diagnostic categories. The use of CBT interventions also varied across diagnoses in line with evidence-based treatment recommendations.

DISCUSSION

Short-term CBT delivered in primary care is associated with significant improvements in anxiety and depression symptoms among participants with anxiety disorders. These findings support the use of a population-based approach to anxiety disorders treatment and suggest that evidence-based CBT can be implemented in the real-world setting.

摘要

背景

焦虑障碍是最常见的心理健康问题之一。患有焦虑症的个体通常会在初级保健而不是专科护理中寻求服务。虽然有大量证据支持认知行为疗法(CBT)治疗焦虑症的疗效和有效性,但在初级保健中,尚无关于焦虑症特定治疗结果的自然主义研究报告。

方法

参与者(N = 1,589)是从一个多州、多地点的初级保健诊所招募的,其中 491 名参与者在基线时报告有中度至重度焦虑,并至少进行了一次 CBT 疗程。数据来自心理治疗跟踪数据库。

结果

在接受 CBT 的中度至重度焦虑患者中,心理治疗过程中焦虑和抑郁症状显著减轻(p<.001,d = 0.57-0.95)。可靠变化、反应和缓解的比率因诊断类别而异。CBT 干预措施的使用也根据循证治疗建议在不同的诊断中有所不同。

讨论

在初级保健中提供的短期 CBT 与焦虑障碍患者的焦虑和抑郁症状的显著改善相关。这些发现支持采用基于人群的方法治疗焦虑障碍,并表明基于证据的 CBT 可以在实际环境中实施。

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