06 Kwi 2009, Pon 16:59, PID: 138227
(Ten post był ostatnio modyfikowany: 06 Kwi 2009, Pon 17:14 przez Sosen.)
In 2006, the efficacy of combination treatments for social phobia (social anxiety disorder) has been assessed in a new randomized controlled trial by Prasko et al. (ref. 4). The authors conducted a study to assess the 6-months treatment efficacy and 24-month follow up of three different therapeutic programs: moclobemide and supportive guidance, group cognitive-behavioral therapy and pill placebo, and combination of moclobemide and group cognitive-behavioral therapy in patients with a generalized form of social phobia.
81 patients (38 males and 43 females) were randomly assigned to one of the three treatments. 66 patients completed the six month treatment period. 15 patients dropped out. All therapeutic groups showed significant improvement. The combination of CBT and pharmacotherapy yielded the most rapid effect. Moclobemide was superior for the reduction of the subjective general anxiety during the first 3 months of treatment, but its influence on avoidant behavior was less pronounced.
Conversely, CBT was the best choice for reduction of avoidant behavior while a reduction of subjective general anxiety appeared later than in moclobemide. After 6 months of treatment the best results were reached in groups treated with CBT and there was no advantage of the combined treatment. The relapse rate during the 24-month follow up was significantly lower in the group treated with CBT in comparison with the group formerly treated with moclobemide alone.
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Podobne badanie, ale na dorosłych. 6 miesięcy. Połączenie metod po tym okresie nie dało większych efektów niż same leki, albo sama terapia. Wniosek może być taki, że starsze osoby zdają sobie już sprawę z nieracjonalności swoich lęków. Dla dzieci połączenie leków z CBT daje większe korzyści.
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Conclusion
The hope that combination treatments might significantly increase the efficacy of current treatments for anxiety disorders has not been confirmed by recent empirical data. This fact is disappointing, all the more since a substantial proportion of patients do not respond or do not fully respond to either pharmacotherapy or CBT alone.
In the acute phase, current treatments for anxiety disorders combining pharmacotherapy and CBT do not seem to be associated with greater overall efficacy than that achieved with either treatment given alone. In the long-term treatment of anxiety disorders, combination treatments may be more effective than pharmacotherapy alone, but not more effective than CBT alone.
Data from the recent literature suggest a complex relationship between pharmacotherapy and CBT and highlight the need for more extensive studies, concerning, in particular, the long-term efficacy and effectiveness of combination treatments, the effect of discontinuation of either treatment after combined treatment, and the use of new strategies for combining pharmacotherapy and CBT.
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Konkluzja z badań(cały artykuł zawierał opisy badań różnych zaburzeń lękowych).
W skrócie.
Nadzieja, że leczenie skojarzone może znacznie zwiększyć efektywność leczenie zaburzeń lękowych nie znalazła potwierdzenia w badaniach.
Połączenie farmakoterapii i CBT w leczeniu zaburzeń lękowych wydaje się nie połączone z większą efektywnością niż leczenie tylko jedną z tych dwóch metod. W długoterminowym leczeniu zaburzeń lękowych skojarzone leczenie może być bardziej efektywne niż sama farmakoterapia, ale nie bardziej efektywne niż sama terapia CBT.
Badania nad terapią skojarzoną muszą być kontynuowane.
81 patients (38 males and 43 females) were randomly assigned to one of the three treatments. 66 patients completed the six month treatment period. 15 patients dropped out. All therapeutic groups showed significant improvement. The combination of CBT and pharmacotherapy yielded the most rapid effect. Moclobemide was superior for the reduction of the subjective general anxiety during the first 3 months of treatment, but its influence on avoidant behavior was less pronounced.
Conversely, CBT was the best choice for reduction of avoidant behavior while a reduction of subjective general anxiety appeared later than in moclobemide. After 6 months of treatment the best results were reached in groups treated with CBT and there was no advantage of the combined treatment. The relapse rate during the 24-month follow up was significantly lower in the group treated with CBT in comparison with the group formerly treated with moclobemide alone.
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Podobne badanie, ale na dorosłych. 6 miesięcy. Połączenie metod po tym okresie nie dało większych efektów niż same leki, albo sama terapia. Wniosek może być taki, że starsze osoby zdają sobie już sprawę z nieracjonalności swoich lęków. Dla dzieci połączenie leków z CBT daje większe korzyści.
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Conclusion
The hope that combination treatments might significantly increase the efficacy of current treatments for anxiety disorders has not been confirmed by recent empirical data. This fact is disappointing, all the more since a substantial proportion of patients do not respond or do not fully respond to either pharmacotherapy or CBT alone.
In the acute phase, current treatments for anxiety disorders combining pharmacotherapy and CBT do not seem to be associated with greater overall efficacy than that achieved with either treatment given alone. In the long-term treatment of anxiety disorders, combination treatments may be more effective than pharmacotherapy alone, but not more effective than CBT alone.
Data from the recent literature suggest a complex relationship between pharmacotherapy and CBT and highlight the need for more extensive studies, concerning, in particular, the long-term efficacy and effectiveness of combination treatments, the effect of discontinuation of either treatment after combined treatment, and the use of new strategies for combining pharmacotherapy and CBT.
-------------------------------------------------------------------------------
Konkluzja z badań(cały artykuł zawierał opisy badań różnych zaburzeń lękowych).
W skrócie.
Nadzieja, że leczenie skojarzone może znacznie zwiększyć efektywność leczenie zaburzeń lękowych nie znalazła potwierdzenia w badaniach.
Połączenie farmakoterapii i CBT w leczeniu zaburzeń lękowych wydaje się nie połączone z większą efektywnością niż leczenie tylko jedną z tych dwóch metod. W długoterminowym leczeniu zaburzeń lękowych skojarzone leczenie może być bardziej efektywne niż sama farmakoterapia, ale nie bardziej efektywne niż sama terapia CBT.
Badania nad terapią skojarzoną muszą być kontynuowane.