Optimizing Psychotherapy for Anxiety Disorders

University of Zurich200 enrolled

Overview

Anxiety disorders are highly prevalent and are associated with a high burden of disease, costs and individual impairment worldwide. Psychotherapy, especially cognitive behavioral therapy (CBT), is the first line treatment for anxiety disorders. CBT is effective in modifying dysfunctional cognitions and reducing avoidance behavior, thus leading to a lasting reduction of symptoms. Even though CBT is generally effective, around 50% of patients do not benefit sufficiently from this treatment. The current study aims at optimizing the treatment of anxiety disorders by identifying predictors of treatment response. Multiple (neuro-)psychological, biological, genetic and behavioral variables will be combined into a comprehensive prediction model of treatment outcome. Knowledge on predictors can then be used to improve therapy on an individual patient level.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

200

Conditions

Anxiety Disorders

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * aged between 18-65 years * one of the following primary axis I disorders according to the Diagnostic and Statistical Manual of Mental Disorders (DSM): Panic Disorder with or without Agoraphobia; Social Anxiety Disorder; Anxiety Disorder not otherwise specified, Adjustment Disorder with Anxiety, Adjustment Disorder with Mixed Anxiety and Depression; Specific Phobia; Generalized Anxiety Disorder * if on medication If on medication or in other types of treatments, patients must be willing to remain stable on their treatment for the duration of the acute phase/therapy of the study * not currently receiving other psychotherapeutic treatment for anxiety or another condition * fluent German * provision of written informed consent Exclusion Criteria: * concomitant psychotherapy * medical relative contraindications involve conditions that impede thorough exposure, e.g. cardiovascular diseases, autoimmune diseases or pregnancy * current or past schizophrenia, psychosis, or bipolar disorder * current suicidal ideation. * current substance/alcohol dependence or abuse * cluster A or B personality disorder * pregnancy (for women)

Outcomes

Primary Outcomes

Hamilton Anxiety Rating Scale

clinician rating of anxiety symptoms, range: 0-56, with higher values representing a worse outcome

Time frame: change from T0 (entry to study) at mid-treatment (8 weeks after T0), change from T0 at post-treatment (after 16 weeks from T0), change from T0 at 6 months follow-up and change from T0 at one year from post-treatment

Overall Anxiety Severity and Impairment Scale

self-report measure of anxiety symptom severity and impairment; range: 0-20, with higher values representing worse outcome

Time frame: change from T0 (entry to study), at mid-treatment (8 weeks after T0), change from T0 at post-treatment (16 weeks after T0), change from T0 at 6 months follow-up and change from T0 at one year post-treatment

Secondary Outcomes

Hamilton Depression Scale

clinician rating of depressive symptoms; range: 0-66, with higher values representing worse outcome

Beck Depression Inventory

self report measure of depression; range: 0-63, with higher values indicating worse outcome

Social Functioning Index (SFI)

change in social functioning; Subscales: "work" (range: 1-15) and "leisure time" (range: 1-30), with higher numbers indicating worse outcome

World Health Organization-5 Wellbeing Index

change in well-being; range: 0-25, with higher values indicating a better outcome

Beck Anxiety Inventory

self-report in anxiety symptoms, range 0-63, with higher values representing worse outcome