Psychodynamic therapy was focused on dependence behaviors and related emotional problems. The randomization process did not work in that study: baseline Hamilton Anxiety, Hamilton Depression, and Handicap scales

were significantly higher in the clomipramine group. Nevertheless, the authors contended that, the combined condition (20% relapses) was superior to clomipramine alone (75% relapses) at. a 9month follow-up. As there was no waiting-list control, Wiborg et al’s41 study does prove a specific effect of psychodynamic therapy in #Ponatinib manufacturer keyword# panic disorder. Generalized anxiety disorder CBT in GAD Methods Since the first operational definition of generalized anxiety disorder Inhibitors,research,lifescience,medical (GAD) in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III),42 the pathogenesis has been clearly concentrated on the concept of excessive worry.43 This cognitive point of view considers the somatic symptoms as secondary manifestations of cognitive processes. Later, the I) SM.-IV“4 paid allegiance to the cognitive model with another criterion: the difficulty in controlling the worry. This new trend

was supported Inhibitors,research,lifescience,medical by numerous studies assessing normal and abnormal thoughts showing the intolerance to uncertainty of GAD subjects. Pathological worry is viewed as shaped by cognitive distortions, which result from maladaptive schemata of danger. Ruminations and attention disturbances Inhibitors,research,lifescience,medical impede normal problem solving in everyday situations and worry represents for the patient an inefficient way to control possible negative events in the future.45 In CBT, the patient is advised to consider his or her catastrophic view up to its ultimate consequences. At this point, Socratic questioning will help him or her substitute more probabilistic views Inhibitors,research,lifescience,medical instead. The patient can also be exposed in imagination to the catastrophic scenes to reach habituation. Then, basic schemata of danger are elicited and questioned. The treatment, format classically involves about. 15 sessions. The different. levels of intervention are cue-controlled relaxation, cognitive restructuring,

problem solving, in vivo exposure to feared real-life situations, and exposure in imagination in order to obtain habituation to highly improbable situations. The aim is to replace the worry by effective coping strategies. Outcomes A meta-analysis by Gould et al46,47 found CBT Carnitine dehydrogenase and pharmacotherapy equally effective. This meta-analysis included 35 controlled studies, which had been published between 1974 and 1996: 13 studies dealt, with CBT and 22 with medication. The size effect was 0.70 for CBT and 0.60 for the pharmacological treatment. However, the drug samples had higher dropout, rates and showed a loss of efficacy at withdrawal, while the effects of CBT were maintained. Studies assessing the CBT plus drug combination were lacking.