Randomized controlled trial of group cognitive behavioral therapy compared to a discussion group for co-morbid anxiety and depression in older adults.
BACKGROUND
Co-morbid anxiety and depression in older adults is associated with worse physical and mental health outcomes and poorer response to psychological and pharmacological treatments in older adults. However, there is a paucity of research focused on testing the efficacy of the co-morbid treatment of anxiety and depression in older adults using psychological interventions. Accordingly, the primary objective of the current study was to test the effects of a group cognitive behavior therapy (CBT) program in treating co-morbid anxiety and depression in a sample of older age adults.


METHODS
A total of 133 community-dwelling participants aged ⩾60 years (mean age = 67.35, s.d. = 5.44, male = 59) with both an anxiety disorder and unipolar mood disorder, as assessed on the Anxiety Disorder Interview Schedule (ADIS), were randomly allocated to an 11-week CBT group or discussion group. Participants with Mini-Mental State Examination scores <26 were excluded. Participants were assessed pre-treatment, post-treatment and at 6 months follow-up on the ADIS, a brief measure of well-being, Geriatric Anxiety Inventory and Geriatric Depression Scale.


RESULTS
Both conditions resulted in significant improvements over time on all diagnostic, symptom and wellbeing measures. Significant group × time interaction effects emerged at post-treatment only for diagnostic severity of the primary disorder, mean severity of all anxiety disorders, mood disorders, and all disorders, and recovery rates on primary disorder.


CONCLUSIONS
Group CBT produced faster and sustained improvements in anxiety and depression on diagnostic severity and recovery rates compared to an active control in older adults.
Department of Psychology,Centre for Emotional Health,Macquarie University,Sydney,Australia.
V M
VM
Wuthrich
Department of Psychology,Centre for Emotional Health,Macquarie University,Sydney,Australia.
R M
RM
Rapee
Department of Psychology,Centre for Emotional Health,Macquarie University,Sydney,Australia.
M
M
Kangas
Department of Psychology,Centre for Emotional Health,Macquarie University,Sydney,Australia.
S
S
Perini
D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000628:therapy*; D001008:Anxiety Disorders / Q000453:epidemiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D003866:Depressive Disorder / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group / Q000379:methods*; D016896:Treatment Outcome
Anxiety; co-morbid; cognitive behavioral therapy; depression; geriatric; late-life; randomized controlled trial; transdiagnostic