414 Self-help therapies of some benefit in anxiety disorders

May 01, 2014

PEARLS 414, December 2013, written by Brian R McAvoy

Clinical question
How effective are media-delivered cognitive behavioural therapy and behavioural therapy (self-help therapies) for anxiety disorders in adults?

Bottom line
Self-help therapies may be superior to no intervention for people with anxiety; there were positive effects on symptoms of anxiety and depression, response and recovery from illness, disability, and quality of life. Face-to-face interventions may be superior to media-delivered interventions. There were differences favouring face-to-face treatment for symptoms of anxiety, but no significant differences in response and recovery from illness, disability and quality of life. However, few studies included follow-up after six months. Effects were maintained after cessation of treatment.

In general, studies were conducted in high-income, English-speaking countries among white, female, middle-aged participants. These results may not generalise to other settings or participants. Trials had high exclusion rates. Evidence regarding harm was lacking, and economic analyses were beyond the scope of this review. Many of the self-help therapy materials used were intended for research and were not available to the public.

Anxiety disorders are the most common mental health problems. They can be chronic and unremitting. Effective treatments are available, but access to services is limited. Self-help therapies aim to deliver treatment with less input from professionals compared with traditional therapies.

Cochrane Systematic Review
Mayo-Wilson E and Montgomery P. Media-delivered cognitive behavioural therapy and behavioural therapy (self-help) for anxiety disorders in adults. Cochrane Reviews, 2013, Issue 9. Art. No.: CD0085330.DOI: 10.1002/14651858. CD005330.pub4. This review contains 101 studies involving 8403 participants

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