Combined pharmacotherapy and psychotherapy

Although common in clinical practice, little is known about the effects of combining pharmacotherapy and psychotherapy for GAD. In the only published study to date, Power et alM1) compared cognitive-behavioural therapy, diazepam, a pill placebo, cognitive-behavioural therapy plus diazepam, and cognitive-behavioural therapy plus a pill placebo in a sample of DSM-III-diagnosed GAD patients. At post-treatment and follow-up, patients in all three cognitive-behavioural therapy conditions were more improved than those who received diazepam or lacebo alone. Although the cognitive-behavioural therapy groups did not differ significantly from each other on any measure, the cognitive-behavioural therapy plus diazepam group improved earliest and had the largest percentage of patients achieving a criterion of clinically significant change on all measures. Unfortunately, the use of DSM-III criteria in this study makes its relevance to GAD as it is currently defined uncertain. In addition, the cognitive-behavioural therapy used was briefer (seven sessions) and less specific than the currently recommended forms.

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