Generalized anxiety disorder(GAD)has harmful effects on physical and mental health and quality of life.Coloring therapy has been reported to have a positive effect on improving patient anxiety and depression.But there...Generalized anxiety disorder(GAD)has harmful effects on physical and mental health and quality of life.Coloring therapy has been reported to have a positive effect on improving patient anxiety and depression.But there are no reported clinical trials examining their effectiveness as a treatment for GAD.This study was planned to evaluate the effectiveness of coloring therapy combined with conventional therapy in improving anxiety,depression,and positive and negative emotions with GAD.This randomized controlled study comprising 88 GAD patients was selected for intervention in different wards.The control group(n=45)was given conventional antianxiety medication and physical therapy,and the experimental group(n=43)received coloring therapy combined with conventional therapy.The Self-Rating Depression Scale,Self-Rating Anxiety Scale(SAS),Hamilton Depression Scale,Hamilton Anxiety Scale(HAMA),and Positive and Negative Affect Scale were assessed in both groups before and 3 weeks after the intervention.After the intervention,there were statistical differences in intra-and inter-group comparisons of anxiety,depression,and positive and negative mood scales in the experimental and control groups(p<.05).The minus in anxiety/positive emotions pre-and postintervention in the experimental group was statistically significant compared to that in anxiety/positive emotions pre-and postintervention in the control group(HAMA:d=1.45,95%confidence interval[CI](0.34,2.57),p=.011;SAS:d=3.87,95%CI(1.73,6.00),p=.001;positive:d=1.76,95%CI(0.17,3.34),p=.030).The minus in depressive/negative emotions pre-and postintervention in the experimental group was not statistically significant compared with that in depressive/negative emotions pre-and postintervention in the control group(p>.05).For GAD patients,adding coloring therapy based on conventional drug therapy and physical therapy can not only reduce depression and negative emotions but also have better effects on reducing anxiety and improving positive emotions than conventional therapy.展开更多
Objective:To observe the clinical efficacy of Yiqiyangxin Chinese medicine compound combined with cognitive therapy on generalized anxiety disorders.Methods:A total of 202 generalized anxiety disorders patients were r...Objective:To observe the clinical efficacy of Yiqiyangxin Chinese medicine compound combined with cognitive therapy on generalized anxiety disorders.Methods:A total of 202 generalized anxiety disorders patients were randomly allocated to a control condition(Paroxetine combined with cognitive therapy) or a treatment condition(Yiqiyangxin Chinese medicine compound combined with cognitive therapy).Subsequently,scores of Hamilton Anxiety Scale(HAMA), Zung Self-rating Anxiety Scale(SAS) and blood routine,urine routine,liver function,renal function,electrocardiogram were detected before treatment,3 months,6 months after treatment and 6 months after medicine withdrawal,respectively.Results:HAMA and SAS scores were significantly reduced in two groups(P【0.001) after treatment,but the differences in HAMA and SAS scores,apparent effect and effectiveness were not significant(P】0.05).HAMA and SAS scores were significantly increased in two groups(P【0.05) after medicine withdrawal,and there were significant differences in HAMA and SAS scores,recurrent disease and adverse reaction(P【0.001). The incidence of recurrent disease and adverse reaction in treatment group was low.Both two groups showed no apparent abnormality in blood routine,urine routine,liver and renal function, and electrocardiogram.Conclusions:Yiqiyangxin Chinese medicine compound combined with cognitive therapy can significantly reduce the recurrence after medicine withdrawal and is effective on generalized anxiety disorders.Furthermore,the incidence of adverse reactions is low. The treatment program is worthy clinic application in the further.展开更多
目的探讨基于互联网的数字失眠认知行为治疗(digital delivery of cognitive behavioral therapy for insomnia,dCBT-I)对广泛性焦虑障碍(generalized anxiety disorder,GAD)患者焦虑、睡眠质量的影响。方法选取2023年4月至10月于湖州...目的探讨基于互联网的数字失眠认知行为治疗(digital delivery of cognitive behavioral therapy for insomnia,dCBT-I)对广泛性焦虑障碍(generalized anxiety disorder,GAD)患者焦虑、睡眠质量的影响。方法选取2023年4月至10月于湖州市第三人民医院就诊的82例GAD患者为研究对象,根据随机数字表法将其分为干预组和对照组,每组各41例。干预组采用基于互联网的dCBT-I,对照组采用线下失眠认知行为治疗。比较两组患者的焦虑和睡眠质量。结果干预后,干预组患者的汉密尔顿焦虑量表评分、匹兹堡睡眠质量指数评分均显著低于对照组,睡眠障碍的信念和态度量表评分显著高于对照组(P<0.05)。结论基于互联网的dCBT-I可有效缓解GAD患者的焦虑情绪,提高睡眠质量。展开更多
Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatm...Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatment challenging. A vital step in treatment of such comorbidity is careful and comprehensive diagnostic assessment. We attempt to explain various psychosocial and pharmacological approaches for treatment of comorbid anxiety and depression. For the psychosocial component, we focus only on generalized anxiety disorder based on the following theoretical models:(1) "the avoidance model";(2) "the intolerance of uncertainty model";(3) "the meta-cognitive model";(4) "the emotion dysregulation model"; and(5) "the acceptance based model". For depression, the following theoretical models are explicated:(1) "the cognitive model";(2) "the behavioral activation model"; and(3) "the interpersonal model". Integration of these approaches is suggested. The treatment of comorbid anxiety and depression necessitates specific psychopharmacological adjustments as compared to treating either condition alone. Serotonin reuptake inhibitors are considered first-line treatment in uncomplicated depression comorbid with a spectrum of anxiety disorders. Short-acting benzodiazepines(BZDs) are an important "bridging strategy" to address an acute anxiety component. In patients with comorbid substance abuse, avoidance of BZDs is recommended and we advise using an atypical antipsychotic in lieu of BZDs. For mixed anxiety and depression comorbid with bipolar disorder, we recommend augmentation of an antidepressant with either lamotrigine or an atypical agent. Combination and augmentation therapies in the treatment of comorbid conditions vis-à-vis monotherapy may be necessary for positive outcomes. Combination therapy with tricyclic antidepressants, gabapentin and selective serotonin/norepinephrine reuptake inhibitors(e.g., duloxetine) are specifically useful for comorbid chronic pain syndromes. Aripiprazole, quetiapine, risperidone and other novel atypical agents may be effective as augmentations. For treatment-resistant patients, we recommend a "stacking approach" not dissimilar from treatment of hypertension In conclusion, we delineate a comprehensive approach comprising integration of various psychosocial approaches and incremental pharmacological interventions entailing bridging strategies, augmentation therapies and ultimately stacking approaches towards effectively treating comorbid anxiety and depression.展开更多
Background Duloxetine is approved for the treatment of generalized anxiety disorder （GAD） in the United States and elsewhere. This study aimed to assess the efficacy, tolerability, and safety of duloxetine in Chines...Background Duloxetine is approved for the treatment of generalized anxiety disorder （GAD） in the United States and elsewhere. This study aimed to assess the efficacy, tolerability, and safety of duloxetine in Chinese patients with GAD. Methods This 9-site study consisted of double-blind treatment for 15 weeks either with duloxetine 60-120 mg or with placebo. Patients with at least moderately severe GAD and a Sheehan Disability Scale （SDS） global functioning impairment total score 〉12 were included in this study. Patients who were randomly assigned to duloxetine received 60 mg for 7 weeks; at that point, for nonresponders the dose was increased to 120 mg for the remaining 8 weeks. The primary efficacy measure was mean change from baseline to endpoint on the Hospital Anxiety and Depression Scale-Anxiety subscale score （HADS-A）. Secondary efficacy measures included the Hamilton Anxiety Rating Scale （HAMA）, the SDS, and pain measures. Safety and tolerability were assessed. Results Baseline characteristics did not differ significantly between treatment groups. Mean age of the subjects （n=210） was 37.6 years, 50.5% were female, and 74.3% completed the 15 weeks treatment. Patients treated with duloxetine had significantly greater improvement compared to placebo on the HADS-A （mean change -6.6 vs. -4.9, respectively, P=0.022）. Improvement in anxiety was greater with duloxetine treatment at 7 weeks and continued through 15 weeks for both the HADS-A and the HAMA total score （0.01 〈 P 〈0.05）. Compared with placebo, duloxetine was also associated with greater improvement on most seconda~ measures, but not on the SDS global functioning score. Nausea, dizziness, and somnolence occurred significantly more frequently as treatment-emergent adverse events with duloxetine treatment compared with placebo treatment. Conclusions Duloxetine 60-120 mg once daily is effective and well-tolerated for the treatment of patients with GAD in China.展开更多
基金the National Natural Science Foundation of China(grant number 31672295)。
文摘Generalized anxiety disorder(GAD)has harmful effects on physical and mental health and quality of life.Coloring therapy has been reported to have a positive effect on improving patient anxiety and depression.But there are no reported clinical trials examining their effectiveness as a treatment for GAD.This study was planned to evaluate the effectiveness of coloring therapy combined with conventional therapy in improving anxiety,depression,and positive and negative emotions with GAD.This randomized controlled study comprising 88 GAD patients was selected for intervention in different wards.The control group(n=45)was given conventional antianxiety medication and physical therapy,and the experimental group(n=43)received coloring therapy combined with conventional therapy.The Self-Rating Depression Scale,Self-Rating Anxiety Scale(SAS),Hamilton Depression Scale,Hamilton Anxiety Scale(HAMA),and Positive and Negative Affect Scale were assessed in both groups before and 3 weeks after the intervention.After the intervention,there were statistical differences in intra-and inter-group comparisons of anxiety,depression,and positive and negative mood scales in the experimental and control groups(p<.05).The minus in anxiety/positive emotions pre-and postintervention in the experimental group was statistically significant compared to that in anxiety/positive emotions pre-and postintervention in the control group(HAMA:d=1.45,95%confidence interval[CI](0.34,2.57),p=.011;SAS:d=3.87,95%CI(1.73,6.00),p=.001;positive:d=1.76,95%CI(0.17,3.34),p=.030).The minus in depressive/negative emotions pre-and postintervention in the experimental group was not statistically significant compared with that in depressive/negative emotions pre-and postintervention in the control group(p>.05).For GAD patients,adding coloring therapy based on conventional drug therapy and physical therapy can not only reduce depression and negative emotions but also have better effects on reducing anxiety and improving positive emotions than conventional therapy.
基金supported in part by Research Program in Higher Edueational Intuitions of the Education Department in Hainan(No.Hjsk2011-53)Natural Seientific Research Funds of Hainan in 2011(No.710247)Scientific Research Funds of Hainan Medical University in 2009(No.2009-035)
文摘Objective:To observe the clinical efficacy of Yiqiyangxin Chinese medicine compound combined with cognitive therapy on generalized anxiety disorders.Methods:A total of 202 generalized anxiety disorders patients were randomly allocated to a control condition(Paroxetine combined with cognitive therapy) or a treatment condition(Yiqiyangxin Chinese medicine compound combined with cognitive therapy).Subsequently,scores of Hamilton Anxiety Scale(HAMA), Zung Self-rating Anxiety Scale(SAS) and blood routine,urine routine,liver function,renal function,electrocardiogram were detected before treatment,3 months,6 months after treatment and 6 months after medicine withdrawal,respectively.Results:HAMA and SAS scores were significantly reduced in two groups(P【0.001) after treatment,but the differences in HAMA and SAS scores,apparent effect and effectiveness were not significant(P】0.05).HAMA and SAS scores were significantly increased in two groups(P【0.05) after medicine withdrawal,and there were significant differences in HAMA and SAS scores,recurrent disease and adverse reaction(P【0.001). The incidence of recurrent disease and adverse reaction in treatment group was low.Both two groups showed no apparent abnormality in blood routine,urine routine,liver and renal function, and electrocardiogram.Conclusions:Yiqiyangxin Chinese medicine compound combined with cognitive therapy can significantly reduce the recurrence after medicine withdrawal and is effective on generalized anxiety disorders.Furthermore,the incidence of adverse reactions is low. The treatment program is worthy clinic application in the further.
文摘目的探讨基于互联网的数字失眠认知行为治疗(digital delivery of cognitive behavioral therapy for insomnia,dCBT-I)对广泛性焦虑障碍(generalized anxiety disorder,GAD)患者焦虑、睡眠质量的影响。方法选取2023年4月至10月于湖州市第三人民医院就诊的82例GAD患者为研究对象,根据随机数字表法将其分为干预组和对照组,每组各41例。干预组采用基于互联网的dCBT-I,对照组采用线下失眠认知行为治疗。比较两组患者的焦虑和睡眠质量。结果干预后,干预组患者的汉密尔顿焦虑量表评分、匹兹堡睡眠质量指数评分均显著低于对照组,睡眠障碍的信念和态度量表评分显著高于对照组(P<0.05)。结论基于互联网的dCBT-I可有效缓解GAD患者的焦虑情绪,提高睡眠质量。
文摘Comorbid anxiety with depression predicts poor outcomes with a higher percentage of treatment resistance than either disorder occurring alone. Overlap of anxiety and depression complicates diagnosis and renders treatment challenging. A vital step in treatment of such comorbidity is careful and comprehensive diagnostic assessment. We attempt to explain various psychosocial and pharmacological approaches for treatment of comorbid anxiety and depression. For the psychosocial component, we focus only on generalized anxiety disorder based on the following theoretical models:(1) "the avoidance model";(2) "the intolerance of uncertainty model";(3) "the meta-cognitive model";(4) "the emotion dysregulation model"; and(5) "the acceptance based model". For depression, the following theoretical models are explicated:(1) "the cognitive model";(2) "the behavioral activation model"; and(3) "the interpersonal model". Integration of these approaches is suggested. The treatment of comorbid anxiety and depression necessitates specific psychopharmacological adjustments as compared to treating either condition alone. Serotonin reuptake inhibitors are considered first-line treatment in uncomplicated depression comorbid with a spectrum of anxiety disorders. Short-acting benzodiazepines(BZDs) are an important "bridging strategy" to address an acute anxiety component. In patients with comorbid substance abuse, avoidance of BZDs is recommended and we advise using an atypical antipsychotic in lieu of BZDs. For mixed anxiety and depression comorbid with bipolar disorder, we recommend augmentation of an antidepressant with either lamotrigine or an atypical agent. Combination and augmentation therapies in the treatment of comorbid conditions vis-à-vis monotherapy may be necessary for positive outcomes. Combination therapy with tricyclic antidepressants, gabapentin and selective serotonin/norepinephrine reuptake inhibitors(e.g., duloxetine) are specifically useful for comorbid chronic pain syndromes. Aripiprazole, quetiapine, risperidone and other novel atypical agents may be effective as augmentations. For treatment-resistant patients, we recommend a "stacking approach" not dissimilar from treatment of hypertension In conclusion, we delineate a comprehensive approach comprising integration of various psychosocial approaches and incremental pharmacological interventions entailing bridging strategies, augmentation therapies and ultimately stacking approaches towards effectively treating comorbid anxiety and depression.
基金National Science and Technology Support Plan[Key Technique of Major Mental Illness Prevention Study](2012BAI01B04)Shanghai "Science and Technology Innovation Action Plan"Science and Technology Support Project in Medicine and Agriculture in 2015(Code:15411950201)Shanghai Construction Plan of Key Medical Specialty(ZK2015A06)
文摘Background Duloxetine is approved for the treatment of generalized anxiety disorder （GAD） in the United States and elsewhere. This study aimed to assess the efficacy, tolerability, and safety of duloxetine in Chinese patients with GAD. Methods This 9-site study consisted of double-blind treatment for 15 weeks either with duloxetine 60-120 mg or with placebo. Patients with at least moderately severe GAD and a Sheehan Disability Scale （SDS） global functioning impairment total score 〉12 were included in this study. Patients who were randomly assigned to duloxetine received 60 mg for 7 weeks; at that point, for nonresponders the dose was increased to 120 mg for the remaining 8 weeks. The primary efficacy measure was mean change from baseline to endpoint on the Hospital Anxiety and Depression Scale-Anxiety subscale score （HADS-A）. Secondary efficacy measures included the Hamilton Anxiety Rating Scale （HAMA）, the SDS, and pain measures. Safety and tolerability were assessed. Results Baseline characteristics did not differ significantly between treatment groups. Mean age of the subjects （n=210） was 37.6 years, 50.5% were female, and 74.3% completed the 15 weeks treatment. Patients treated with duloxetine had significantly greater improvement compared to placebo on the HADS-A （mean change -6.6 vs. -4.9, respectively, P=0.022）. Improvement in anxiety was greater with duloxetine treatment at 7 weeks and continued through 15 weeks for both the HADS-A and the HAMA total score （0.01 〈 P 〈0.05）. Compared with placebo, duloxetine was also associated with greater improvement on most seconda~ measures, but not on the SDS global functioning score. Nausea, dizziness, and somnolence occurred significantly more frequently as treatment-emergent adverse events with duloxetine treatment compared with placebo treatment. Conclusions Duloxetine 60-120 mg once daily is effective and well-tolerated for the treatment of patients with GAD in China.
