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Review
. 2011;13(4):413-21.
doi: 10.31887/DCNS.2011.13.4/cotte.

Cognitive behavioral therapy in anxiety disorders: current state of the evidence

Christian Otte  1
Affiliations
Review

Cognitive behavioral therapy in anxiety disorders: current state of the evidence

Christian Otte. Dialogues Clin Neurosci. 2011.

Abstract
in English, Spanish, French

A plethora of studies have examined the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for adult anxiety disorders. In recent years, several meta-analyses have been conducted to quantitatively review the evidence of CBT for anxiety disorders, each using different inclusion criteria for studies, such as use of control conditions or type of study environment. This review aims to summarize and to discuss the current state of the evidence regarding CBT treatment for panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Overall, CBT demonstrates both efficacy in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders. However, due to methodological issues, the magnitude of effect is currently difficult to estimate. In conclusion, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but more high-quality studies are needed to better estimate the magnitude of the effect.

Existen numerosos estudios que ban examinado la eficacia y efectividad de la terapia cognitivo conductual (TCC) para los trastornos ansiosos del adulto. En los ultimos anos se han efeciuado varios meta-anâiisis para revisar cuantitativamenie la evidencia de la TCC para los trastornos ansiosos, los que han empleado diferentes criterios de inclusion para los estudios, como el uso de condiciones control o el tipo de ambiente del estudio. El objetivo de esta revisión es resumir y discutir la situación actual de la evidencia en relación con el tratamienio de la TCC para el trastorno de pánico, el trastorno de ansiedad generalizada, el trastorno de ansiedad social, el trastorno obsesivo compulsivo y el trastorno por estrés postraumático. La TCC ha demostrado globalmente eficacia en ensayos controlados randomizados y efectividad en estudios naturalísticos en el tratamiento de los trastornos ansiosos del adulto. Sin embargo, debido a aspectos metodológicos, la magnitud del efecto actualmente resulta dificil de estimar. En conclusion, la TCC aparece como un tratamiento eficaz y efectivo para los trastornos ansiosos, pero se requiere de más estudios de alta calidad para una mejor estimación de la magnitud del efecto.

Une pléthore d'études a examiné l'efficacité de la thérapie cognitivo-comportementale (TCC) dans les troubles anxieux de l'adulte. Ces dernières années, plusieurs metaanalyses ont été menées pour examiner quantitativement la preuve de l'efficacité des TCC dans les troubles anxieux, chacune utilisant des critères d'inclusion différents pour les études, comme l'utilisation des conditions de contrôle ou le type d'environnement de l'étude. Cet article a pour but de résumer et analyser l'état actuel des connaissances sur la TCC des troubles paniques, des troubles anxieux généralisés, des troubles anxieux sociaux, des troubles obsessionnels compulsifs et de l'état de stress post-traumatique. Globalement, la TCC démontre une efficacité à la fois dans les études contrôlées randomisées ainsi qu'en conditions naturelles dans le traitement des troubles anxieux de l'adulte. Cependant, l'amplitude de l'effet est actuellement difficile à évaluer du fait de problèmes méthodologiques. Pour conclure, la TCC semble être efficiente et efficace pour traiter les troubles anxieux, mais il faut des études de meilleure qualité afin de mieux estimer l'importance de son effet

Keywords: acute stress disorder; anxiety disorder; cognitive-behavioral therapy; generalized anxiety disorder; meta-analysis; obsessive-compulsive disorder; panic disorder; post-traumatic stress disorder; psychotherapy.

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Figures

Figure 1.
Figure 1.. Average effect size estimates and corresponding 95% confidence intervals of the acute treatment efficacy of cognitive-behavioral therapy as compared with placebo on the various anxiety disorders for the primary continuous anxiety measure (dark blue bars) and depression measures (light blue bars) Adapted from ref 6: Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry. 2008;69:621-632. Copyright© Physicians' Postgraduate Press, 2008
Figure 2.
Figure 2.. Average odds ratios of acute treatment response to cognitive-behavioral therapy as compared with placebo. *, P<0.05; **, P<0.01 Adapted from ref 6: Hofmann SG, Smits JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry. 2008;69:621-632. Copyright© Physicians' Postgraduate Press, 2008
See this image and copyright information in PMC

References

    1. Kessler RC., Berglund P., Dernier O., Jin R., Merikangas KR., Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602. - PubMed
    1. Kessler RC., Ruscio AM., Shear K., Wittchen HU. Epidemiology of anxiety disorders. Curr Top Behav Neurosci. 2010;2:21–35. - PubMed
    1. Olatunji BO., Cisler JM., Deacon BJ. Efficacy of cognitive behavioral therapy for anxiety disorders: a review of meta-analytic findings. Psychiatr Clin N Am. 2010;33:557–577. - PubMed
    1. Butler AC., Chapman JE., Forman EM., Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26:17–31. - PubMed
    1. Stewart RE., Chambless DL. Cognitive-behavioral therapy for adult anxiety disorders in clinical practice: a meta-analysis of effectiveness studies. J Consult Clin Psychol. 2009;77:595–606. - PMC - PubMed

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