Wirksamkeit der kognitiven Verhaltenstherapie bei generalisierten Angsterkrankungen – Ergebnisseder Berliner KVT-GAD-Studie

Abstract

Effectiveness of the Cognitive Behavior Therapy in the Treatment of Generalized Anxiety Disorders – Results of the Berlin GAD-KVT-Study Background: In recent years generalized anxiety disorders (GAD) have become a focus of clinical research. There is some empirical evidence that cognitive behavior therapy (CBT) is an effective treatment. But the available studies have some shortcomings which do not allow generalizations to treatment under routine conditions. Method: In a multicenter controlled clinical trial supported by the Deutsche Forschungsgemeinschaft, efficacy of manual-guided CBT was studied in cooperation with behavior therapists who work in private practice. The design and methodology of the study adhere to the same rules as are valid in pharmacotherapy trials. Patients treated with CBT (TA) were compared with those of a waiting contact group (KKG). Because the control group patients were also treated with CBT after the waiting period (TB), a validation of treatment results has been possible. 72 outpatients (age 18–65 years, HAM-A ≧ 18, GAD according to DSM-IV, no co-morbid axis-I or axis-II disorders, no co-medication) were included and randomized into the study arms. Results: In TA HAM-A showed a reduction pre-post of 10.64 (39.6%) and STAI state of 7.96 (15.1%). In TB (those patients with delayed start of therapy) the reduction in the HAM-A was 12.08 (56.9%) and in the STAI state 6.62 (13.5%). In KKG the reduction was 1.22 (5.3%) in the HAM-A and 1.63 (3.2%) in the STAI state. Differences between TA or TB and KKG were statistically highly significant. Conclusion: The data show that manual-guided CBT is effective in GAD. Results are statistically significant and clinically meaningful. The study also shows that multicenter trials are also feasible in psychotherapy research.

Therapist–Patient Alliance, Patient–Therapist Alliance, Mutual Therapeutic Alliance, Therapist–Patient Concordance, and Outcome of CBT in GAD

“…Duration of treatment was a mean of 44.8 weeks for CBT-A and 43 weeks for CBT-B. Protocol adherence of each therapist was ensured in several ways and shown to be good (Linden et al, 2002(Linden et al, , 2004(Linden et al, , 2005. Cognitive behavior therapy turned out to be an effective method in the treatment for GAD.…”

“…The clinical improvement remained stable over a follow-up period of 8 months. More details on design and results can be found in Linden et al (2002Linden et al ( , 2004.…”

Bedeutung, Erfassung und Veränderung interpersonaler Problemmuster in der Psychotherapieforschung : Eine Untersuchung mit dem Inventar zur Erfassung interpersonaler Probleme

“…In the observer rated measures, the patients yielded a HAMA mean score of M=23.77 (SD=6.64). These scores are comparable to the results of another German GAD sample reported by Linden, Bär, Zubrägel, Ahrens, and Schlattmann (2002). With regard to depression, the GAD patients yielded a BDI mean score of M=16.13 (SD=8.19), which can be interpreted as moderate depressive symptoms, and a HAMD mean score of M=14.77 (SD=6.20).…”

Heilsame Kreativität

“…Die Arbeitszeit war seinerzeit eine sehr fortschrittliche Bewegung in den psychiatrischen Anstalten, stand aber immer wieder im Spannungsfeld zwischen therapeutischen und ökonomischen Aspekten [Deister, 2003] [Turkot, 2001;Tzaut und Baron, 1998;Kivnick und Erikson, 1983;Malley et al, 2002;Spaniol, 2001;Pendleton, 1999;Luber, 1978;Kerklau, 2001;Diamond und Orrell-Valente, 2002;Mallay, 2002;Schoenewolf, 2002;Steinbauer et al, 2000] Schippan et al [2004], die ihre Konzeption spezieller «weisheitsaktivierender Problemlöse-strategien» bei der posttraumatischen Verbitterungsstörung vorstellen. Schippan gehört zur Forschungsgruppe von Linden, der für seine Arbeit «Kognitive Verhaltenstherapie bei generalisierten Angststörungen» in VERHALTENSTHERAPIE [Linden et al, 2002] …”