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Occupational functioning, sickness absence and medication utilization before and after cognitive–behaviour therapy for generalized anxiety disorders
Author(s) -
Linden Michael,
Zubrägel Doris,
Bär Thomas
Publication year - 2011
Publication title -
clinical psychology and psychotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.315
H-Index - 76
eISSN - 1099-0879
pISSN - 1063-3995
DOI - 10.1002/cpp.712
Subject(s) - anxiety , psychology , psychiatry , generalized anxiety disorder , cognition , sick leave , clinical psychology , occupational therapy , medicine , physical therapy
Background: Cognitive–behaviour therapy (CBT) is efficacious in reducing symptoms of generalized anxiety disorders (GAD). The question is whether it is also efficient, i.e., whether there are also enduring effects with respect to improving utilization of medication and psychotherapy, or occupational functioning and sick leave after the end of treatment. Method: The study was based on 44 outpatients (age 18–65 years; HAM‐A score ≥18; GAD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria as assessed by standardized interview) who were treated with 25 sessions of CBT (treatment by 12 state‐licensed behaviour therapists in office‐based practice; no psychotropic treatment for the duration of the therapy). The rate of medication treatment, occupational functioning and sick leave was assessed for 8 months before and after the end of treatment. Results: In the comparison of the pre‐treatment and post‐treatment periods, 46.5% versus 7.2% of patients used psychotropic medication for at least 4 weeks and had been 3.1 versus 1.1 days on sickness absence per month, respectively. About 70% of patients showed impairment in occupational role performance during the pre‐treatment phase compared with 5% to 20%, depending on the dimension, in the follow‐up period. Conclusions: The data suggest that CBT is not only efficacious in terms of symptom reduction but also efficient in terms of reducing inappropriate medication intake and improving occupational functioning. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Effects of any treatment should not only pertain to the present symptomatology but also to illness behaviour and occupational and social participation. • When patients with GAD are treated with CBT, a reduction in sickness absence and an improvement of occupational functioning can be observed in the post‐treatment period. • After CBT, a reduction of inappropriate medication can be seen. • The data suggest that CBT in GAD patients reduces not only illness symptoms but also improves illness behaviour and role adjustment.