title: Cognitive-behavioural therapy for anxiety in dementia: pilot randomised controlled trial.
abstract: BACKGROUND
  Anxiety is common and problematic in dementia, yet there is a lack of effective treatments.
  
  
  OBJECTIVE
  To develop a cognitive-behavioural therapy (CBT) manual for anxiety in dementia and determine its feasibility through a randomised controlled trial.
  
  
  METHODS
  A ten-session CBT manual was developed. Participants with dementia and anxiety (and their carers) were randomly allocated to CBT plus treatment as usual (TAU) (n = 25) or TAU (n = 25). Outcome and cost measures were administered at baseline, 15 weeks and 6 months.
  
  
  RESULTS
  At 15 weeks, there was an adjusted difference in anxiety (using the Rating Anxiety in Dementia scale) of (-3.10, 95% CI -6.55 to 0.34) for CBT compared with TAU, which just fell short of statistical significance. There were significant improvements in depression at 15 weeks after adjustment (-5.37, 95% CI -9.50 to -1.25). Improvements remained significant at 6 months. CBT was cost neutral.
  
  
  CONCLUSIONS
  CBT was feasible (in terms of recruitment, acceptability and attrition) and effective. A fully powered RCT is now required.
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Aimee
authors.initials: A
authors.lastname: Spector
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Georgina
authors.initials: G
authors.lastname: Charlesworth
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Miles
authors.initials: M
authors.lastname: Lattimer
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Sadek
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Marston
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Amritpal
authors.initials: A
authors.lastname: Rehill
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Juanita
authors.initials: J
authors.lastname: Hoe
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Afifa
authors.initials: A
authors.lastname: Qazi
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Knapp
authors.affiliation: Aimee Spector, PhD, DClinPsy, Georgina Charlesworth, ClinPsyD, PhD, Research Department of Clinical, Educational and Health Psychology, University College London, London; Michael King, MD, PhD, Division of Psychiatry, University College London, London; Miles Lattimer, BSc, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Susan Sadek, ClinPsyD, Department of Clinical Psychology, University of East Anglia, Norwich; Louise Marston, PhD, Department of Primary Care and Population Health, University College London, London; Amritpal Rehill, BSc, Personal Social Services Research Unit, London School of Economics and Political Science, London; Juanita Hoe, RMN, PhD, Department of Mental Health Sciences, University College London, London; Afifa Qazi, MBBS, MRCPsych, North East London NHS Foundation Trust, Goodmayes Hospital, Ilford; Martin Knapp, PhD, Personal Social Services Research Unit, London School of Economics and Political Science, London; Martin Orrell, PhD, Division of Psychiatry, University College London, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Orrell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000191:economics / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000191:economics / Q000379:methods*; D003365:Costs and Cost Analysis; D003704:Dementia / Q000191:economics / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D016037:Single-Blind Method; D016896:Treatment Outcome