Metacognitive therapy versus cognitive–behavioral therapy in adults with generalized anxiety disorder: A 9‐year follow‐up study

Solem, Stian; Wells, Adrian; Kennair, Leif Edward Ottesen; Hagen, Roger; Nordahl, Hans M.; Hjemdal, Odin

doi:10.1002/brb3.2358

Cited by 23 publications

(19 citation statements)

References 20 publications

(26 reference statements)

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“…CAS is a pattern of repetitive negative thinking in the process of worrying and ruminating. MCT focuses on raising awareness of rumination and removing the behavior, developing new responses to negative thoughts, and improving selective attention control [ 67 , 68 ]. Ferraro et al evidenced the therapeutic impact of MCT on the perception of tinnitus and its anxiety and depression correlates [ 69 ].…”

Section: Discussionmentioning

confidence: 99%

The Comorbidity of Depression and Anxiety Symptoms in Tinnitus Sufferers: A Network Analysis

et al. 2023

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Objective: Sufferers of tinnitus, especially of the prolonged type, frequently suffer from comorbid depression and anxiety. From the perspective of the network model, this comorbidity is thought to be an interacting system of these two symptoms. In our study, we conducted a network analysis of depression and anxiety comorbidity in tinnitus sufferers, aiming to identify the central and bridge symptoms and make informed suggestions for clinical interventions and psychotherapy. Method: A total of 566 tinnitus sufferers were enrolled in our study. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder 7-Item Questionnaire (GAD-7) were selected to evaluate depression and anxiety symptoms, respectively, followed by network analysis to construct the interacting networks. Results: The findings identified six edges of strongest regularized partial correlations in this network. Of these, three were depression symptoms and three were anxiety symptoms. The anxiety symptoms “Unable to control worry” and “Relaxation difficulty” and the depression symptom “Feeling depressed or hopeless” had the highest expected influence centrality. The analysis results also revealed three bridge symptoms: “Afraid something awful might happen”, “Feeling of worthlessness”, and “Trouble concentrating”. As for “Suicidal ideation”, the direct relations between this symptom and “Afraid something awful might happen” and “Feeling depressed or hopeless” were the strongest. Conclusions: The central and bridge symptoms of the interacting network of depression and anxiety symptoms in tinnitus sufferers can be considered a significant transdiagnostic intervention target for the management of this comorbidity. In particular, clinical prevention and psychotherapy should be implemented, targeting the symptoms that have the strongest associations with suicidal ideation.

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Section: Discussionmentioning

confidence: 99%

The Comorbidity of Depression and Anxiety Symptoms in Tinnitus Sufferers: A Network Analysis

et al. 2023

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“…The trial uses MCT according to the manual [ 31 ] and work-focused interventions according to the work-module that has shown promising outcomes in a previous observational study [ 34 ]. The MCT interventions and the work-focused interventions are provided in the same session by the same therapist.…”

Section: Methodsmentioning

confidence: 99%

“…In recent years, metacognitive therapy (MCT) has shown excellent results in treating depression and anxiety [ 27 ]. Recent studies on MCT in Norway have shown recovery rates of 65% and 70% for anxiety and depression, with similar rates at 1 and 3-year follow-up [ 28 – 31 ]. In Denmark a comparison of MCT with CBT for depression showed that MCT was superior, achieving a 74% recovery rate compared with 52% in CBT [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Metacognitive therapy and work-focused interventions for patients on sick leave due to anxiety and depression: study protocol for a randomised controlled wait-list trial

Sandin

Gjengedal

Osnes

et al. 2021

Trials

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Background Common mental disorders such as depression and anxiety are major contributors to the global burden of disease. Affected individuals suffer reduced quality of life, impaired functioning and reduced capacity to work. Maintaining employment is an important determinant for health and wellbeing, and the economic impact of depression and anxiety is a significant societal expense. Treatments providing effective symptom reduction and helping patients return to work (RTW) would thus have substantial public health benefits. The present study will explore the effectiveness of metacognitive therapy (MCT) and work-focused interventions on reducing symptoms and increasing RTW rates for patients on sick leave due to depression and anxiety. Methods The study is a randomised controlled wait-list trial (RCT; N = 240). The intervention group will receive protocol-based MCT and work-focused interventions immediately after inclusion. The control condition is a wait-list control group. All patients will receive up to 12 weekly sessions. The study context is a Norwegian outpatient clinic part of a national programme aimed at reducing sick leave. The co-primary outcomes are change in RTW and symptoms of depression and anxiety at the end of treatment. In addition to self-report, sick leave will also be collected from national registries from 2 years prior to intervention to 4 years after intervention. Symptoms of scores will be collected by self-report at pre- and post-treatment and at 6 and 12 months follow-up after treatment. A cost-effectiveness analysis will use total cost and quality-adjusted life-years as the secondary outcomes. Discussion There is broad consensus on the importance of identifying treatment that effectively reduces depression and anxiety symptoms and aids RTW. This study is an important contribution to the field as it is the first RCT on MCT and work-focused interventions for patients on sick leave due to anxiety and depression. Trial registration ClinicalTrials.gov NCT03301922. Registered on October 4, 2017.

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“…Patients in the MCT condition showed significantly more improvement in symptoms of worry and anxiety. In the CBT group, 23.1% were re-diagnosed with GAD, compared with 9.5% in the MCT group [30].…”

Section: Psychological Therapymentioning

confidence: 86%

Update on treatments for anxiety-related disorders

Lee

Stein

2022

Current Opinion in Psychiatry

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Purpose of reviewThis review examines recent evidence that informs the treatment of anxiety-related disorders.Recent findingsIn addition to selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and benzodiazepines, agomelatine has demonstrated efficacy in treating generalized anxiety disorder (GAD). Other novel products, such as ketamine, psilocybin and cannabidiol, are in the process of gathering evidence in support of the treatment of anxiety disorders. In psychological therapy, various psychological treatments for anxiety disorders, such as mindfulness-based intervention, acceptance and commitment therapy, psychodynamic therapy, emotion-focused therapy and dialectical behavioural therapy, have been tried. Still, most therapies have not proven superior to cognitive behavioural therapy (CBT). In very preliminary findings: Repetitive transcranial magnetic stimulation (rTMS) was effective in GAD; transcranial direct current stimulation (tDCS) was effective for social anxiety disorder (SAD) and GAD and augmented exposure therapy for specific fears. Internet and mobile-based interventions have comparable efficacy to face-to-face therapy.SummaryPharmacotherapy of anxiety disorders is expanding to novel products. Despite trying other psychological therapies for anxiety disorders, most therapies were comparable to but not superior to CBT. rTMS and tDCS were also used and show early promise for GAD, but further studies are needed. Most internet or mobile app based psychological therapies were based on CBT, and some can be considered as alternatives to in-person face-to-face therapy.

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Metacognitive therapy versus cognitive–behavioral therapy in adults with generalized anxiety disorder: A 9‐year follow‐up study

Cited by 23 publications

References 20 publications

The Comorbidity of Depression and Anxiety Symptoms in Tinnitus Sufferers: A Network Analysis

The Comorbidity of Depression and Anxiety Symptoms in Tinnitus Sufferers: A Network Analysis

Metacognitive therapy and work-focused interventions for patients on sick leave due to anxiety and depression: study protocol for a randomised controlled wait-list trial

Update on treatments for anxiety-related disorders

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