Thesis or Dissertation Effects of psychotherapy for middle-aged individuals with anxiety disorders in a general medicine practice

長浦, 由紀

60 ( 2 )  , pp.61 - 68 , 2015-09-02 , 長崎大学医学部
Background: Anxiety disorders are mental disorders that cause somatic symptoms for which patients may seek care from general medicine departments. We focused on anxiety disorders in middle-aged patients and examined the effect of a psychotherapeutic intervention. Materials and Methods: The participants were 14 middle-aged patients diagnosed with an anxiety disorder. Patients received pretreatment assessments and were randomly assigned to a pharmacotherapy group (n = 8) or a pharmacotherapy and psychotherapy group (n = 6). The duration of the study was three months. Pre-and post-treatment, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS) were administered. In the pharmacotherapy and psychotherapy group, salivary cortisol was collected pre- and post-psychotherapy at the first and final psychotherapy sessions. Result: Four patients in the pharmacotherapy group withdrew from the study. There were no significant differences in the total scores of the SF-36 or STAI between groups. Improvement was seen in the pharmacotherapy and psychotherapy group pre- and post- treatment. SF-36 subscales of bodily pain (p = 0.02) and mental health (p = 0.04) were significantly higher than posttreatment. The state anxiety score on the STAI improved post-treatment (p = 0.03). On the VAS, the pharmacotherapy and psychotherapy group’s symptoms were significantly improved (p = 0.02). Conclusion: This suggests that psychotherapy for middle-aged individuals contributes to the improvement of anxiety states and HRQoL in general medicine departments. It promotes the recognition of curative effects and prevents doctor shopping.

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