CBT for anxiety in primary care comparable to longer treatments

January 01, 0001

CBT for anxiety in primary care comparable to longer treatments

Psychological therapies provided in primary care are usually briefer than in secondary care. There has been no recent comprehensive review comparing their effectiveness for common mental health problems. The researchers aimed to compare the effectiveness of different types of brief psychological therapy administered within primary care across and between anxiety, depressive and mixed disorders using meta-analysis and meta-regression of randomized controlled trials of brief psychological therapies of adult patients with anxiety, depression or mixed common mental health problems treated in primary care compared to primary care treatment as usual. Thirty-four studies, involving 3962 patients, were included.

Most studies were of brief cognitive behaviour therapy (CBT; n=13), counselling (n=8) or problem solving therapy (PST; n=12). There was differential effectiveness between studies of CBT, with studies of CBT for anxiety disorders having a pooled effect size greater than that of studies of CBT for depression or studies of CBT for mixed anxiety and depression. Counselling for depression and mixed anxiety and depression and problem solving therapy (PST) for depression and mixed anxiety and depression were also effective. Controlling for diagnosis, meta-regression found no difference between CBT, counselling and PST.

The researchers concluded: "Brief CBT, counselling and PST are all effective treatments in primary care, but effect sizes are low compared to longer length treatments. The exception is brief CBT for anxiety, which has comparable effect sizes."

Still worth pursuing, with improved skills and effectiveness. Not just about general practice.

For the full abstract, click here.

BMC Medicine 2010 (8):38, 25 June 2010 © 1999-2010 BioMed Central Ltd
Brief psychological therapies for anxiety and depression in primary care: meta-analysis and meta- regression. John Cape, Craig Whittington, Marta Buszewicz, Paul Wallace and Lisa Underwood. Correspondence to John Cape: [email protected]

Category: P. Psychological. Keywords: brief, psychological, therapies, anxiety, depression, primary care, meta-analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 23 July 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.