title: Meta-analysis of randomized controlled comparisons of psychopharmacological and psychological treatments for anxiety disorders.
abstract: BACKGROUND
  A number of meta-analyses have led to contradictory results regarding the efficacy of the psychological and pharmacological treatment of anxiety disorders. The main reasons for these inconsistent results seem to be the inclusion of heterogeneous studies and influences of selection biases. We performed a meta-analysis, which only included studies using a direct comparison of pharmacological, psychological, or combined treatments.
  
  
  METHODS
  Sixteen studies on panic disorder, six studies on social anxiety disorder, and two studies on generalized anxiety disorder have been analyzed. Effect sizes for differences between the different treatment modalities were calculated. Also, the effect sizes of the pre-post differences were calculated.
  
  
  RESULTS
  Pharmacological treatment, cognitive-behavioural treatment, and the combination of both treatment modalities all led to substantial improvement between pre- and post-treatment. Combined pharmacological and psychological treatment was superior to the monotherapies for panic disorder. For social anxiety disorder, there is only preliminary support for combined treatment. Due to lack of sufficient data, no final conclusions can be drawn for generalized anxiety disorder.
  
  
  CONCLUSIONS
  While drug treatment and CBT showed equal efficacy, only in panic disorder the combination of pharmacological and psychological treatment was superior to either treatment alone. For the other anxiety disorders, the evidence for greater efficacy of combination treatment is still not sufficient due to lack of studies.
authors.affiliation: Department of Psychiatry and Psychotherapy, The University of Göttingen, Göttingen, Germany. Sekretariat.Bandelow@medizin.uni-goettingen.de
authors.forename: Borwin
authors.initials: B
authors.lastname: Bandelow
authors.forename: Ulrich
authors.initials: U
authors.lastname: Seidler-Brandler
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
authors.forename: Dirk
authors.initials: D
authors.lastname: Wedekind
authors.forename: Eckart
authors.initials: E
authors.lastname: Rüther
mesh_terms: D001008:Anxiety Disorders / Q000188:drug therapy / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004358:Drug Therapy / Q000379:methods*; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic