Evidence Base for Anxiety Disorders

3270 Words Nov 15th, 2013 14 Pages
1. Introduction

This paper provides a brief overview of evidence based psychological treatments for anxiety disorders. It addresses the following questions:

• How common are anxiety disorders? • What psychological treatments have empirical support? • What recovery rates can be achieved with these treatments? • How enduring are their effects? • Is there value in combining psychological treatments with medication?

Psychological treatments can be delivered in a variety of formats. This paper restricts itself to the traditional, and most extensively researched, format of face-to-face contact with a fully qualified therapist. For most anxiety disorders the therapy sessions are once weekly for 60-90 minutes
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No other psychological treatment was considered by NICE to be effective in anxiety disorders in general. However, Eye Movement Desensitization Reprocessing (which some people argue is a form of CBT) was supported in posttraumatic stress disorder.

NICE has not yet commissioned guidance for the two remaining anxiety disorders (social phobia and specific phobia) or for a closely linked condition that is common in primary care (hypochondriasis/severe health anxiety). However, the RCT findings for each of these disorders are very similar to those obtained in the four disorders that are currently covered by NICE guidance. In particular, for each disorder there are RCTs that show that CBT is: superior to no treatment5-9, superior to a similarly credible alternative psychosocial treatment5 7 10 11, and at least as effective as medication12-16. No other psychological treatment approach for these disorders has been supported in randomized controlled trials.

Although non-CBT approaches have not yet received significant support in RCTs, a recent non-randomized comparison between CBT and two other therapies has been interpreted by some media commentators as evidence that non-CBT approaches are as effective as CBT. This interpretation is unwarranted. In the study17 NHS therapists working in primary and secondary care were invited to use a standardized symptom questionnaire (the CORE-OM) with their patients and to submit the questionnaires to a central
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