A Controlled Comparison of Cognitive—Behaviour Therapy, Diazepam and Placebo in the Management of Generalized Anxiety

Abstract

Generalized anxiety patients were randomly allocated to Cognitive-Behaviour Therapy, Diazepam or Placebo and managed in a primary care setting. Treatments were balanced for degree of psychologist/patient contact. A range of outcome measures, including patient self report, psychologist assessor and general practitioner ratings were used. Large variations within group response to treatment emerged. At the end of active treatment the superiority of Cognitive-Behaviour Therapy was suggested. Post-study psychotropic prescription and psychological treatment was assessed at a 12-month follow-up. The Cognitive-Behaviour group revealed the lowest incidence of subsequent treatment interventions.

Psychological treatment of anxiety in primary care: a meta-analysis

“…outcome of costeffectiveness, psychological treatment combined with pharmacotherapy, no control group, or evaluations of other research). Twelve manuscripts (Lindsay et al 1987 ;Power et al 1989Power et al , 1990Sorby et al 1991 ;Sharp et al 1996Sharp et al , 1997Sharp et al , 2004Blomhoff et al 2001 ;Stanley et al 2003Stanley et al , 2009van Boeijen et al 2005b ;Wetherell et al 2009) met all inclusion criteria, in which 13 psychological treatment conditions were compared to a control group. Two manuscripts (Sharp et al 1996(Sharp et al , 1997 described different outcomes for one study.…”

Empirically supported individual and group psychological treatments for adult mental disorders.

“…Nine clinical trials were reviewed, with one ( Butler, Cullington, Hibbert, Klimes, & Gelder, 1987 ) investigating a similar cognitive-behavioral package rather than Beck and Emery's model per se. Most of the other eight studies ( Barlow et al, 1984 ;Blowers, Cobb, & Mathews, 1987 ;Borkovec & Costello, 1993 ;Borkovec & Mathews, 1988 ;Borkovec, Mathews, Chambers, & Ebrahimi, 1987 ;Butler, Fennell, Robson, & Gelder, 1991 ;Power, Jerrom, Simpson, Mitchell, & Swanson, 1989 ;Power et al, 1990 ) combined cognitive techniques described by Beck and Emery with other behavioral techniques, although the Beck and Emery approach was the primary treatment. Comparisons with control groups (wait list, nondirective therapy, or pill placebo) yielded an average effect size of 1.5.…”

‘‘Stress Control’’ Large Group Therapy for Generalized Anxiety Disorder: Two Year Follow-Up

“…Several studies have now looked at longer follow-up points; Borkovec and Costello (1993) produce evidence of clear maintenance of gains in cognitive-behavioural and applied relaxation treatments at 12 month follow-up. Power, Jerrom, Simpson, Mitchell and Swanson (1989) reported on the number of (drug-free at start of treatment) patients who were prescribed psychotropic medication and͞or were given further psychological treatment in the year following treatment; 30%, 70% and 55% of cognitive therapy, diazepam and pill placebo patients respectively required further help. Of 44 patients completing treatment, Barlow et al (1992) show high endstate functioning (using a composite measure) in 4 of the 19 patients interviewed at 24 month follow-up.…”