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Evidence Base for Anxiety Disorders

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Submitted By lemmywinks
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1. Introduction

This paper provides a brief overview of evidence based psychological treatments for anxiety disorders. It addresses the following questions:

• How common are anxiety disorders? • What psychological treatments have empirical support? • What recovery rates can be achieved with these treatments? • How enduring are their effects? • Is there value in combining psychological treatments with medication?

Psychological treatments can be delivered in a variety of formats. This paper restricts itself to the traditional, and most extensively researched, format of face-to-face contact with a fully qualified therapist. For most anxiety disorders the therapy sessions are once weekly for 60-90 minutes spread over a period of 8-20 weeks, with homework assignments in between. However, in specific phobias, the strongest outcomes have been obtained with a single, long (3-5 hour) session with a therapist, followed by a briefer follow-up session a week or so later.

2. How common are anxiety disorders?

The most recent British Psychiatric Morbidity Survey1 estimates that 16.4% of the population have a diagnosable anxiety and/or depressive disorder. The diagnostic system that was used in the survey (ICD-10) is different from the diagnostic system (DSM-IV) that has been used in most trials of psychological treatments. For this reason, it is difficult to be precise about the number of individuals in the UK who have anxiety disorders for which there is an evidence based psychological treatment. The key difference between the two diagnostic systems is that ICD-10 has a mixed anxiety and depression category whereas DSM-IV does not. However, it seems reasonable to assume that about half of the UK cases of “anxiety and/or depressive disorder” will have problems that were the focus of treatment in anxiety disorder treatment trials. In other

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