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患者症状和优势作为认知行为疗法治疗广泛性焦虑障碍长期结局的预测因素:一项三水平、多预测因子分析。

Patients' symptoms and strengths as predictors of long-term outcomes of CBT for generalized anxiety disorder - A three-level, multi-predictor analysis.

机构信息

University of Zurich, Switzerland; University of Kassel, Germany.

University of Zurich, Switzerland.

出版信息

J Anxiety Disord. 2022 Dec;92:102635. doi: 10.1016/j.janxdis.2022.102635. Epub 2022 Sep 24.

Abstract

Although cognitive behavioral therapy (CBT) is an effective treatment for generalized anxiety disorder (GAD), GAD often shows a chronic clinical course and common deterioration after treatment. Many trials have examined the efficacy of treatments in GAD, but little is known about intake predictors of long-term treatment outcomes. This study examined potential predictors of long-term treatment outcomes based on the individual's symptom severity and strengths (behavioral, cognitive, interpersonal) at intake. Long-term outcomes were defined as worry at six-month follow-up (six-m FU) and worry decrease from intake and post-treatment to six-m FU. Data from 137 CBT outpatients with a GAD diagnosis from two randomized clinical trials were analyzed using three-level hierarchical linear modeling. Results revealed that worrying decreased up to the six-m FU. In single-predictor models, intake symptom severity and strength measures predicted worry at the six-m FU. In multi-predictor models, only behavioral strengths remained a significant predictor. Worry decrease from intake to the six-m FU was only predicted by behavioral strengths. These findings provide relevant information about intake predictors of long-term outcomes after CBT for GAD and underscore the potential relevance of assessing patients' strengths for clinical practice.

摘要

虽然认知行为疗法(CBT)是治疗广泛性焦虑症(GAD)的有效方法,但 GAD 通常表现为慢性临床病程,并且在治疗后常见恶化。许多试验已经检验了 GAD 治疗的疗效,但对于长期治疗结果的摄入预测因素知之甚少。本研究根据个体在摄入时的症状严重程度和优势(行为、认知、人际),检查了长期治疗结果的潜在预测因素。长期结果定义为六个月随访时的担忧(六 FU)以及从摄入和治疗后到六个月随访时的担忧减少。使用三级层次线性模型分析了来自两项随机临床试验的 137 名接受 CBT 的 GAD 门诊患者的数据。结果表明,担忧情况在六个月随访时有所减轻。在单预测因子模型中,摄入时的症状严重程度和优势测量指标预测了六个月随访时的担忧情况。在多预测因子模型中,只有行为优势仍然是一个重要的预测指标。从摄入到六个月随访时的担忧减少仅由行为优势预测。这些发现为 GAD 的 CBT 后长期结果的摄入预测因素提供了相关信息,并强调了评估患者优势对于临床实践的潜在相关性。

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