Subject:
Anxiety Disorders

Short Description:

CBT Moderately Effective in Improving Quality of Life for Anxiety Disorders

Background:

Cognitive behavioral therapy (CBT) has been shown to be effective in reducing the symptoms of anxiety disorders. But there’s not a lot of information about whether it improves patients’ quality of life (QoL), even though one would think improvement in QoL is inherent when anxiety is reduced.

A recent meta-analysis looked at 44 studies, including 59 CBT trials involving 3,326 participants who received CBT for a variety of anxiety disorders, to determine the effects of the treatment on QoL.

The meta-analysis concluded that CBT has a beneficial effect on QoL, especially when it is provided face-to-face, either individually or in groups, as opposed to online. Researchers found improvements were greater for physical (ie, energy, pain, sleep) and psychological (ie, emotions, self-esteem, cognition, bodily image) domains of QoL than for environmental (ie, finances, safety/security, participation in recreation, etc.) and social (ie, personal relationships, social support, sexual activity) domains.

The overall effect on QoL increased with the duration of treatment, suggesting brief treatments may not achieve the desired outcome, although the research did not identify an “ideal” length of treatment. While symptoms of anxiety might respond within only a few sessions, longer treatment may be necessary to noticeably improve a patient’s QoL.

Of the 59 clinical trials, 22 provided individual CBT delivered face-to-face, 14 provided group CBT delivered face-to-face, and 23 delivered CBT via the Internet. The face-to-face treatments delivered individually and in groups to patients produced significantly higher effect sizes on QoL than Internet-delivered treatments (Hofmann SG et al, J Consult Clin Psychol 2014;82(3):375–391).

TCPR’s Take: These findings support the use of CBT to enhance QoL in a wide range of anxiety disorders. This meta-analysis, however, did not compare CBT to medication management, nor did it compare the effectiveness of CBT on QoL among different anxiety disorders. Effect sizes for in-person treatments were greater than those for online treatments, but head-to-head trials comparing the two types of treatment are lacking.