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September 9, 2010

researchlogo72x65bl-new.jpgA recent study published in The Journal of the American Medical Association compared the effectiveness of Evidence-Based Treatment against usual care for multiple types of anxiety disorders.  The participants consisted of 1004 patients with varying anxiety disorders including panic, generalized anxiety, social anxiety, and post-traumatic stress disorder in 17 primary care clinics in 4 US cities.The researchers used a Brief Symptom Inventory (BSI) to measure both anxiety and somatic symptoms.  These initial scores were compared with follow-up measurements taken after 6, 12 and 18 months of either Coordinated Anxiety Learning and Management (CALM) or usual care.

The CALM model allowed participants in the intervention group to choose between Cognitive Behavior Therapy (CBT), medication alone, or CBT combined with medication. Real-time web-based outcomes monitoring was also incorporated to optimize treatment decisions, as well as a computer-assisted program to optimize the delivery of CBT. Results showed that CALM techniques were significantly more effective than usual care in reducing global anxiety symptoms.  Patients undergoing CALM treatment had significantly reduced scores on the Brief Symptom Inventory.  These patients also had higher response and remission rates.   Response was defined as at least a 50% reduction on the BSI or meeting the definition of remission.  Remission was defined as an anxiety score between none and mild. The results of this trial illustrate the effectiveness of Evidence-Based Treatment, specifically Coordinated Anxiety Learning and Management in real-world practice settings. CALM proved to be more effective than usual care for multiple types of anxiety disorders.  This trial indicated that Evidence-Based Treatment may be of greater help to patients with anxiety disorders than those measures currently being used.

Roy-Byrne, P., Craske, M. G., Sullivan, G., Rose, R. D., Edlund, M. J., Lang, A. J., Bystritsky, A., Welch, S. S., Chavira, D. A., Golinelli, D., Campbell-Sills, L., Sherbourne, C. D., & Stein, M. B.  (2010).  Delivery of evidence-based treatment for multiple anxiety disorders in primary care.  The Journal of the American Medical Association, 303, 1921-1928.