Enduring effects of psychological treatments for anxiety disorders: meta-analysis of follow-up studies

作者：Borwin Bandelow, Anne Sagebiel, Michael Belz, Yvonne Görlich, Sophie Michaelis, Dirk Wedekind · 发表于：The British Journal of Psychiatry · 年份：2018 · DOI：10.1192/bjp.2018.49 · 被引用次数：74 · 研究领域：Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes、Psychotherapy Techniques and Applications、Pain Management and Placebo Effect

BACKGROUND: It is a widespread opinion that after treatment with psychotherapy, patients with anxiety disorders maintain their gains beyond the active treatment period, whereas patients treated with medication soon experience a relapse after treatment termination.AimsWe aimed to provide evidence on whether enduring effects of psychotherapy differ from control groups. METHOD: We searched 93 randomised controlled studies with 152 study arms of psychological treatment (cognitive-behavioural therapy or other psychotherapies) for panic disorder, generalised anxiety disorder and social anxiety disorder that included follow-up assessments. In a meta-analysis, pre-post effect sizes for end-point and all follow-up periods were calculated and compared with control groups (medication: n = 16 study arms; pill and psychological placebo groups: n = 17 study arms). RESULTS: Gains with psychotherapy were maintained for up to 24 months. For cognitive-behavioural therapy, we observed a significant improvement over time. However, patients in the medication group remained stable during the treatment-free period, with no significant difference when compared with psychotherapy. Patients in the placebo group did not deteriorate during follow-up, but showed significantly worse outcomes than patients in cognitive-behavioural therapy. CONCLUSIONS: Not only psychotherapy, but also medications and, to a lesser extent, placebo conditions have enduring effects. Long-lasting treatment effects observed in t...