Long-Term Outcomes of CBT for Anxiety-Related Disorders

introduction

Anxiety disorders, PTSD, and OCD are highly prevalent and associated with substantial personal and societal costs

Many patients favor psychotherapy over pharmacotherapy

CBT is generally associated with reduced symptoms in the short-term; we lack long-term data on CBT outcomes

Four meta-analyses have been conducted on long-term outcomes, and they indicate a medium effect size

limitations

Control groups not always included

Lack of data around relapse rate (31%-55% with remitted anxiety meet DSM-5 criteria within 4 years)

aims

Comprehensive meta-analysis to establish long-term outcomes of CBT

Assess relapse rates

inclusion criteria

examination effects of CBT at least 1 month after treatment completion
comparison group
adult patients with diagnosis of anxiety or PTSD or OCD

exclusion criteria

did not use CBT or used CBT and meds together
inpatient population

how many studies met criteria

69 published studies met criteria that represented 4118 patients

Discussion

CBT was associated with moderate symptom reductions up to 12 months after treatment

Long-term effects not significant for panic disorder

Perhaps power was an issue (results indicate the absence of evidence rather than the evidence of absence)

Evidence suggests treatment gains are stable for 12 months (“but do not improve further”)

Minimal data on relapse