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Cited by 35Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and AssessmentsPsychotherapy Techniques and Applications

CBT for pharmacotherapy non-remitters—a systematic review of a next-step strategy

Rodrigues, Helga, Figueira, Ivan, Gonçalves, Raquel, Mendlowicz, Mauro, Macedo, Tânia, Ventura, Paula·2011·Journal of Affective Disorders
DOI 10.1016/j.jad.2010.08.025
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Abstract

Background Non-remission rates to pharmacotherapy for anxiety disorders are related to higher relapse rates, decreased quality of life and greater functional impairment. Here we sought to investigate the efficacy of cognitive-behavior therapy (CBT) as a next-step strategy in the treatment of patients with anxiety disorders who did not remit after a pharmacological intervention.Method We carried out a systematic review in the ISI, Pubmed and PsycINFO/PsychLit databases. Studies that did not use CBT and that did not focus on resistance to drug therapy were excluded. We considered resistant patients who failed to respond (did not fully remit) to an adequate trial of pharmacotherapy and still exhibited residual symptoms of anxiety disorder.Results We identified 603 references in our survey, of which 17 were included: eight were on OCD, five on panic disorder, and four on PTSD. No studies were found on social anxiety disorder and generalized anxiety disorder. We observed a lack of standardization of terminology and of definitions of resistance, which makes comparison of results difficult. Finally, all of the identified studies showed benefits from the addition of CBT as a next-step strategy.Limitations A limited number of randomized controlled studies were found.Conclusions CBT seems to be a promising next-step strategy for patients with anxiety disorders who did not remit with drug-based therapies. However, further clinical trials with strong methodological designs are needed to definitely establish its efficacy in this population.

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  • A previous review found significant efficacy of adjunctive cognitive behavioral therapy as a next-step strategy in pharmacotherapy non-remitted panic disorder patients.

    “whereas a previous review found significant efficacy of adjunctive CBT as a next-step strategy in this population of patients [43].”

    From Management of Treatment-Resistant Panic Disorder (2017) · cites this paper as [43]

  • Even when psychological treatments are examined, they are usually administered either directly following or in combination with pharmacology.

    “Even when psychological treatments are examined, they are usually administered either directly following or in combination with pharmacology [6] .”

    From Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial. (2015) · cites this paper as [6]

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Authors
Rodrigues, H., Figueira, I., Gonçalves, R., Mendlowicz, M., Macedo, T., & Ventura, P.
Affiliations
Universidade Federal do Rio de Janeiro (BR)
Corresponding author
Rodrigues, Helga
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2011-03
Volume
129
Issue
1-3
Pages
219-228
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2010.08.025
OpenAlex
W1968739183
Cited by
35
References
41
Citations by year
2025: 2 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 6 · 2015: 3 · 2014: 5 · 2013: 2 · 2012: 4
FWCI
0.32
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
cognitive behavioral therapy, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, residual symptoms, relapse
MeSH terms
Anxiety Disorders, Humans, Obsessive-Compulsive Disorder, Stress Disorders, Post-Traumatic, Anti-Anxiety Agents, Cognitive Behavioral Therapy, Panic Disorder, Treatment Outcome, Treatment Failure

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