Medication vs. CBT for Generalized Anxiety Disorder

Citing a relative scarcity of research on the efficacy of CBT for GAD as compared to pharmacotherapy, Kristin Mitte conducted a meta-analysis of 65 controlled studies using a random-effects model to produce results that could be generalized beyond the selected studies. A “trim-and-fill analysis” was also conducted to correct for publication bias, several additional sensitivity analyses were performed to ensure the robustness of the selected studies, and methodological differences were controlled for. Studies utilizing new techniques in CBT such as mindfulness practices and interpersonal interventions were excluded due to insufficient research.

The analysis found CBT to be a highly effective treatment for GAD, “reducing not only the main symptoms of anxiety but also the associated depressive symptoms and subsequently improving quality of life.” Mitte determined that CBT was at least as effective as benzodiazapenes, and approximately as effective as SSRIs and azapirones (such as buspirone) while being far better tolerated than any of these three pharmacological treatments. It is concluded that, although methodological variations make it impossible to determine which of the  GAD treatments considered is the best, CBT is a valuable alternative to pharmacotherapy for treating GAD.

Citation:  Mitte, K. (2005). Meta-analysis of cognitive-behavioral treatments for generalized anxiety disorder : A comparison with pharmacotherapy. Psychological Bulletin, 131(5), 785-795.

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