Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults

Psychol Med. 2016 Mar;46(4):785-95. doi: 10.1017/S0033291715002251. Epub 2015 Oct 26.

Abstract

Background: Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults.

Method: A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale.

Results: Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder.

Conclusion: Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.

Keywords: Anxiety; co-morbid; cognitive behavioral therapy; depression; geriatric; late-life; randomized controlled trial; transdiagnostic.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety / epidemiology
  • Anxiety / therapy*
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Comorbidity
  • Depression / epidemiology
  • Depression / therapy*
  • Depressive Disorder / epidemiology
  • Depressive Disorder / therapy*
  • Female
  • Humans
  • Independent Living
  • Male
  • Middle Aged
  • Psychotherapy, Group / methods*
  • Treatment Outcome

Associated data

  • ANZCTR/ACTRN12611000527965