title: Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial.
abstract: BACKGROUND
  Although massage is one of the most popular complementary and alternative medical (CAM) treatments for anxiety, its effectiveness has never been rigorously evaluated for a diagnosed anxiety disorder. This study evaluates the effectiveness of therapeutic massage for persons with generalized anxiety disorder (GAD).
  
  
  METHODS
  Sixty-eight persons with GAD were randomized to therapeutic massage (n=23), thermotherapy (n=22), or relaxing room therapy (n=23) for a total of 10 sessions over 12 weeks. Mean reduction in anxiety was measured by the Hamilton Anxiety Rating Scale (HARS). Secondary outcomes included 50% reduction in HARS and symptom resolution of GAD, changes in depressive symptoms (Patient Health Questionnaire (PHQ-8)), worry and GAD-related disability. We compared changes in these outcomes in the massage and control groups posttreatment and at 6 months using generalized estimating equation (GEE) regression.
  
  
  RESULTS
  All groups had improved by the end of treatment (adjusted mean change scores for the HARS ranged from -10.0 to -13.0; P<.001) and maintained their gains at the 26-week followup. No differences were seen between groups (P=.39). Symptom reduction and resolution of GAD, depressive symptoms, worry and disability showed similar patterns.
  
  
  CONCLUSIONS
  Massage was not superior to the control treatments, and all showed some clinically important improvements, likely due to some beneficial but generalized relaxation response. Because the relaxing room treatment is substantially less expensive than the other treatments, a similar treatment packaged in a clinically credible manner might be the most cost effective option for persons with GAD who want to try relaxation-oriented CAM therapies.
authors.affiliation: Group Health Research Institute, Seattle, Washington 98101, USA. sherman.k@ghc.org
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Sherman
authors.forename: Evette J
authors.initials: EJ
authors.lastname: Ludman
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Cook
authors.forename: Rene J
authors.initials: RJ
authors.lastname: Hawkes
authors.forename: Peter P
authors.initials: PP
authors.lastname: Roy-Byrne
authors.forename: Susan
authors.initials: S
authors.lastname: Bentley
authors.forename: Marissa Z
authors.initials: MZ
authors.lastname: Brooks
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Cherkin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D000529:Complementary Therapies / Q000379:methods; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D012064:Relaxation Therapy / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult