title: Quality of life and marital adjustment after cognitive behavioural therapy and behavioural marital therapy in couples with anxiety disorders.
abstract: BACKGROUND
  Anxiety disorders may affect nearly one in four persons and may cause significant impairment of interpersonal relationships including marital relationships. The effect of the disorder on the spouse and the impact of including the spouse in therapy are not well studied.
  
  
  OBJECTIVE
  To determine if Cognitive Behavioural Therapy (CBT) improves the quality of life of participants with anxiety disorders and if marital adjustment of couples with anxiety disorders can be improved with Behavioural Marital Therapy (BMT), relative to standard care of pharmacotherapy and psychoeducation.
  
  
  METHODS
  An open label randomised controlled trial. Participants were randomly assigned to CBT+BMT or standard of care. Final assessments were carried out at 3.5 months after baseline. Quality of life was assessed using the WHOQOL-Bref instrument and Marital adjustment was measured using a marital quality scale. Chi-square test, student's t-test and Analysis of Variance (ANOVA) and Effect sizes with Cohen's d were used to compare differences between groups.
  
  
  RESULTS
  Clinically meaningful effect sizes for the CBT+ BMT intervention were evident for the marital adjustment scores among participants (d=0.63) and their spouses (d=1.29), and for the psychological (d=0.84), social (d=0.72) and environmental (d=0.52) domains of the WHOQOL of participants and psychological (d=0.86), social (d=0.32) and environmental domains (d=1.01) of the WHOQOL of spouses of participants.
  
  
  CONCLUSIONS
  CBT for the partner with anxiety disorder and BMT for couples with anxiety disorders and marital discord and involvement of the spouse in the therapy will be a useful addition to the management of a couple where one partner has an anxiety disorder.
authors.affiliation: Consultant and Founder, Department of Clinical Psychology, Manasvin's Center for Marital and Family Therapy , Anand Nagar Colony, Khairatabad, Hyderabad, India .
authors.forename: Chirumamilla
authors.initials: C
authors.lastname: Kavitha
authors.affiliation: Professor (Retd), Department of Psychology, Osmania University , Hyderabad, India .
authors.forename: Uma
authors.initials: U
authors.lastname: Rangan
authors.affiliation: Director, Department of Woman and Child Health Research Unit, Fernandez Hospital , Hyderabad, India .
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Nirmalan
keywords: Anxiety disorders; Behaviour marital therapy; Cognitive behaviour therapy; Marital adjustment; Quality of life