Abstract | CONTEXT:
Anxiety disorders commonly present in primary care, where evidence-based mental health treatments often are unavailable or suboptimally delivered. OBJECTIVE: DESIGN: A randomized controlled trial comparing the Coordinated Anxiety Learning and Management (CALM) intervention with UC at baseline and at 6-, 12-, and 18-month follow-up assessments. SETTING: Seventeen US primary care clinics. PATIENTS: Referred primary care sample, 1004 patients, with principal DSM-IV diagnoses of GAD (n = 549), PD (n = 262), SAD (n = 132), or PTSD (n = 61) (mean [SD] age, 43.7 [13.7] years; 70.9% were female). Eighty percent of the participants completed 18-month follow-up. INTERVENTIONS: CALM (cognitive behavior therapy and pharmacotherapy recommendations) and UC. MAIN OUTCOME MEASURES: RESULTS: CALM was superior to UC for principal GAD at 6-month (-1.61; 95% confidence interval [CI], -2.42 to -0.79), 12-month (-2.34; -3.22 to -1.45), and 18-month (-2.37; -3.24 to -1.50), PD at 6-month (-2.00; -3.55 to -0.44) and 12-month (-2.71; -4.29 to -1.14), and SAD at 6-month (-7.05; -12.11 to -2.00) outcomes. CALM was superior to UC for comorbid SAD at 6-month (-4.26; 95% CI, -7.96 to -0.56), 12-month (-8.12, -11.84 to -4.40), and 18- month (-6.23, -9.90 to -2.55) outcomes. Effect sizes favored CALM but were not statistically significant for other comorbid disorders. CONCLUSIONS:
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Authors | Michelle G Craske, Murray B Stein, Greer Sullivan, Cathy Sherbourne, Alexander Bystritsky, Raphael D Rose, Ariel J Lang, Stacy Welch, Laura Campbell-Sills, Daniela Golinelli, Peter Roy-Byrne |
Journal | Archives of general psychiatry
(Arch Gen Psychiatry)
Vol. 68
Issue 4
Pg. 378-88
(Apr 2011)
ISSN: 1538-3636 [Electronic] United States |
PMID | 21464362
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Chemical References |
- Anti-Anxiety Agents
- Antidepressive Agents
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Topics |
- Adult
- Anti-Anxiety Agents
(therapeutic use)
- Antidepressive Agents
(therapeutic use)
- Anxiety Disorders
(drug therapy, therapy)
- Cognitive Behavioral Therapy
(methods)
- Evidence-Based Medicine
(methods)
- Female
- Humans
- Male
- Primary Health Care
(methods)
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