In the April issue of the Journal of the American Medical Association, the results of a controlled, randomised trial showed that cognitive behavioural therapy (CBT) may help older adults with generalised anxiety disorder (GAD).
Only pilot studies were conducted in primary care, where late life adults often seek treatment for GAD. CBT has been shown to be effective in treating panic disorder in younger patients, GAD and both in addition to being effective for older patients suffering from depression. However, the treatment response rates and effect sizes were lower than for academic clinical trials.
The study took 134 older adults split into two groups, one treated with CBT and one with enhance usual care (EUC). CBT included cognitive therapy, motivational interviews, relaxation training and problem solving training. EUC included biweekly telephone calls and minimal support. The patients were evaluated at the start, after the three months treatment and followed up at six, nine, 12 and 15 months. When compared with EUC, CBT showed significant reductions in the severity levels of worry and in symptoms of depression, as well as improvement in general mental health. The study authors concluded:
"Compared with EUC, CBT resulted in greater improvement in worry severity, depressive symptoms, and general mental health for older patients with GAD in primary care. However, a measure of GAD severity did not indicate greater improvement with CBT … CBT is useful for older adults with GAD in primary care."