Short-term psychodynamic psychotherapy and cognitive-behavioral therapy in generalized anxiety disorder: a randomized, controlled trial.
OBJECTIVE
While several studies have shown that cognitive-behavioral therapy (CBT) is an efficacious treatment for generalized anxiety disorder, few studies have addressed the outcome of short-term psychodynamic psychotherapy, even though this treatment is widely used. The aim of this study was to compare short-term psychodynamic psychotherapy and CBT with regard to treatment outcome in generalized anxiety disorder.


METHODS
Patients with generalized anxiety disorder according to DSM-IV were randomly assigned to receive either CBT (N=29) or short-term psychodynamic psychotherapy (N=28). Treatments were carried out according to treatment manuals and included up to 30 weekly sessions. The primary outcome measure was the Hamilton Anxiety Rating Scale, which was applied by trained raters blind to the treatment conditions. Assessments were carried out at the completion of treatment and 6 months afterward.


RESULTS
Both CBT and short-term psychodynamic psychotherapy yielded significant, large, and stable improvements with regard to symptoms of anxiety and depression. No significant differences in outcome were found between treatments in regard to the primary outcome measure. These results were corroborated by two self-report measures of anxiety. In measures of trait anxiety, worry, and depression, however, CBT was found to be superior.


CONCLUSIONS
The results suggest that CBT and short-term psychodynamic psychotherapy are beneficial for patients with generalized anxiety disorder. In future research, large-scale multicenter studies should examine more subtle differences between treatments, including differences in the patients who benefit most from each form of therapy.
Leichsenring
Falk
F
Department of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany. falk.leichsenring@psycho.med.uni-giessen.de
Salzer
Simone
S
Jaeger
Ulrich
U
Kächele
Horst
H
Kreische
Reinhard
R
Leweke
Frank
F
Rüger
Ulrich
U
Winkelbach
Christel
C
Leibing
Eric
E
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010352:Patient Dropouts / Q000706:statistics & numerical data; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D011614:Psychotherapy, Brief; D016896:Treatment Outcome