Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials

Emily Carl, Sara M. Witcraft, Brooke Y. Kauffman, Eilis M. Gillespie, Eni S. Becker, Pim Cuijpers, Michael Van Ameringen, Jasper A.J. Smits, Mark B. Powers

Research output: Contribution to journalReview article

Abstract

The purpose of this meta-analysis was to provide updated pooled effect sizes of evidence-based psychotherapies and medications for generalized anxiety disorder (GAD) and to investigate potential moderators of outcomes. Seventy-nine randomized controlled trials (RCT) including 11,002 participants with a diagnosis of GAD were included in a meta-analysis that tested the efficacy of psychotherapies or medications for GAD. Psychotherapy showed a medium to large effect size (g = 0.76) and medication showed a small effect size (g = 0.38) on GAD outcomes. Psychotherapy also showed a medium effect on depression outcomes (g = 0.64) as did medications (g = 0.59). Younger age was associated with a larger effect size for psychotherapy (p < 0.05). There was evidence of publication bias in psychotherapy studies. This analysis found a medium to large effect for empirically supported psychotherapy interventions on GAD outcomes and a small effect for medications on GAD outcomes. Both groups showed a medium effect on depression outcomes. Because medication studies had more placebo control conditions than inactive conditions compared to psychotherapy studies, effect sizes between the domains should not be compared directly. Patient age should be further investigated as a potential moderator in psychotherapy outcomes in GAD.

Original languageEnglish (US)
Pages (from-to)1-21
Number of pages21
JournalCognitive Behaviour Therapy
Volume49
Issue number1
DOIs
StatePublished - Jan 2 2020

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Anxiety Disorders
Psychotherapy
Meta-Analysis
Randomized Controlled Trials
Pharmacology
Psychology
Therapeutics
Depression
Publication Bias
Placebos

Keywords

  • GAD
  • generalized anxiety disorder
  • medication
  • meta-analysis: randomized controlled trial
  • therapy

ASJC Scopus subject areas

  • Clinical Psychology

Cite this

Psychological and pharmacological treatments for generalized anxiety disorder (GAD) : a meta-analysis of randomized controlled trials. / Carl, Emily; Witcraft, Sara M.; Kauffman, Brooke Y.; Gillespie, Eilis M.; Becker, Eni S.; Cuijpers, Pim; Van Ameringen, Michael; Smits, Jasper A.J.; Powers, Mark B.

In: Cognitive Behaviour Therapy, Vol. 49, No. 1, 02.01.2020, p. 1-21.

Research output: Contribution to journalReview article

Carl, Emily ; Witcraft, Sara M. ; Kauffman, Brooke Y. ; Gillespie, Eilis M. ; Becker, Eni S. ; Cuijpers, Pim ; Van Ameringen, Michael ; Smits, Jasper A.J. ; Powers, Mark B. / Psychological and pharmacological treatments for generalized anxiety disorder (GAD) : a meta-analysis of randomized controlled trials. In: Cognitive Behaviour Therapy. 2020 ; Vol. 49, No. 1. pp. 1-21.
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