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Cognitive behaviour treatment of co-occurring depression and generalised anxiety in routine clinical practice

Shafran, R; Wroe, A; Nagra, S; Pissaridou, E; Coughtrey, A; (2018) Cognitive behaviour treatment of co-occurring depression and generalised anxiety in routine clinical practice. PLoS One , 13 (7) , Article e0201226. 10.1371/journal.pone.0201226. Green open access

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Abstract

BACKGROUND: Anxiety and depression are closely associated. However, they are typically treated separately and there is a dearth of information on tackling them together. AIMS: The study's purpose was to establish how best to treat co-occurring anxiety and depression in a routine clinical service-specifically, to compare cognitive behaviour therapy (CBT) focusing only on depression (CBT-D) to a broader CBT focusing on both depression and anxiety (CBT-DA). METHOD: Case notes of 69 patients with equally severe clinical levels of depression and anxiety seen in a routine clinical service were randomly selected to review from a pool of 990 patients. The mean age was 44.61 years (SD = 12.97). 65% of the sample were female and 88% reported their ethnicity white. The content of electronic records reporting techniques used and scores on a measure of depression (The Patient Health Questionnaire) and anxiety (The Generalized Anxiety Disorder Assessment) were reviewed to categorise therapy as CBT-D or CBT-DA. RESULTS: Results indicated significant overall improvement with CBT; 70% and 77% of the sample met criteria for reliable improvement on The Patient Health Questionnaire and The Generalized Anxiety Disorder Assessment respectively. Fewer patients who received CBT-DA met The Generalized Anxiety Disorder Assessment recovery criteria at the end of treatment than those who received CBT-D. Mean post treatment PHQ-9 and GAD-7 scores remained above threshold for those receiving CBT_DA but not those receiving CBT-D. There was no evidence suggesting CBT-DA was superior to CBT-D. CONCLUSIONS: In patients with equally severe clinical levels of depression and anxiety, a broader treatment addressing both anxiety and depression does not appear to be associated with improved outcomes compared to treatment focused on depression.

Type: Article
Title: Cognitive behaviour treatment of co-occurring depression and generalised anxiety in routine clinical practice
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0201226
Publisher version: https://doi.org/10.1371/journal.pone.0201226
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10053691
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