Cognitive behavior therapy (CBT) delivered in a primary-care setting can help older patients manage worry and associated symptoms, according to a recent study.
In the trial, 134 primary-care patients aged 60 years and older who had been diagnosed with generalized anxiety disorder received treatment. Seventy of the patients underwent CBT in their primary-care clinic. Therapists conducted up to 10 individual sessions over the course of 12 weeks, covering such elements as education and awareness, motivational interviewing, relaxation training, cognitive therapy, problem-solving skills training, and behavioral sleep management.
The remaining patients were randomized to enhanced usual care: They received calls from the therapists once every two weeks to make sure they were safe and to give them minimal support.
Worry severity significantly decreased in those undergoing CBT compared with the usual-care patients, as did depressive symptoms and general mental health. Scores on the Penn State Worry Questionnaire improved by an average of 7.7 points in the therapy group, compared with an average of 3.2 points for usual-care participants.
The authors called their findings “the first to demonstrate positive effects of treatment for [generalized anxiety disorder] in primary care” (JAMA. 2009;301:1460-1467).