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Meta-Analysis
. 2020 Jan;49(1):1-21.
doi: 10.1080/16506073.2018.1560358. Epub 2019 Feb 14.

Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials

Emily Carl  1 , Sara M Witcraft  2 , Brooke Y Kauffman  3 , Eilis M Gillespie  4 , Eni S Becker  5 , Pim Cuijpers  6 , Michael Van Ameringen  7 , Jasper A J Smits  1 , Mark B Powers  1   8
Affiliations
Meta-Analysis

Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials

Emily Carl et al. Cogn Behav Ther. 2020 Jan.

Abstract

The purpose of this meta-analysis was to provide updated pooled effect sizes of evidence-based psychotherapies and medications for generalized anxiety disorder (GAD) and to investigate potential moderators of outcomes. Seventy-nine randomized controlled trials (RCT) including 11,002 participants with a diagnosis of GAD were included in a meta-analysis that tested the efficacy of psychotherapies or medications for GAD. Psychotherapy showed a medium to large effect size (g = 0.76) and medication showed a small effect size (g = 0.38) on GAD outcomes. Psychotherapy also showed a medium effect on depression outcomes (g = 0.64) as did medications (g = 0.59). Younger age was associated with a larger effect size for psychotherapy (p < 0.05). There was evidence of publication bias in psychotherapy studies. This analysis found a medium to large effect for empirically supported psychotherapy interventions on GAD outcomes and a small effect for medications on GAD outcomes. Both groups showed a medium effect on depression outcomes. Because medication studies had more placebo control conditions than inactive conditions compared to psychotherapy studies, effect sizes between the domains should not be compared directly. Patient age should be further investigated as a potential moderator in psychotherapy outcomes in GAD.

Keywords: GAD; generalized anxiety disorder; medication; meta-analysis: randomized controlled trial; therapy.

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Conflict of interest statement

Disclosure statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Flowchart of inclusion of studies.
Figure 2.
Figure 2.
Effect sizes of treatments for GAD in adults compared with control conditions: Hedges' g.
Figure 3.
Figure 3.
Funnel plot for psychotherapy studies with imputed studies and adjusted effect size.
See this image and copyright information in PMC

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