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Treatment of Anxiety Disorders in a Psychology Clinic

Published online by Cambridge University Press:  30 October 2015

Francisco J. Labrador ,
Francisco J. Estupiñá ,
Mónica Bernaldo-de-Quirós ,
Ignacio Fernández-Arias ,
Pablo Alonso ,
Francisco Ballesteros ,
Carmen Blanco  and
Laura Gómez
Francisco J. Labrador
Affiliation:
Universidad Complutense (Spain)
Francisco J. Estupiñá*
Affiliation:
Universidad Complutense (Spain)
Mónica Bernaldo-de-Quirós
Affiliation:
Universidad Complutense (Spain)
Ignacio Fernández-Arias
Affiliation:
Universidad Complutense (Spain)
Pablo Alonso
Affiliation:
Universidad Complutense (Spain)
Francisco Ballesteros
Affiliation:
Universidad Complutense (Spain)
Carmen Blanco
Affiliation:
Universidad Complutense (Spain)
Laura Gómez
Affiliation:
Universidad Complutense (Spain)
*
*Correspondence concerning this article should be addressed to Francisco J. Estupiñá. Facultad de Psicología. Campus de Somosaguas. Universidad Complutense de Madrid. CP 28223. Pozuelo de Alarcón. Madrid. (Spain). Phone: +34–913942832. E-mail: [email protected]
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Abstract

People with anxiety disorders demand psychological attention most often. Therefore, it seems important to identify both the characteristics of the patients who demand help and the clinical variables related to that demand and its treatment. A cohort of 292 patients who requested help at a university clinical facility was studied. The typical profile of the patient was: being female, young, unmarried, with some college education, and having previously received treatment, especially pharmacological one. The three most frequent diagnoses of anxiety, which include 50% of the cases, were: Anxiety Disorder not otherwise specified, Social Phobia, and Panic Disorder with Agoraphobia. Regarding the characteristics of the intervention, the average duration of the assessment was 3.5 sessions (SD = 1.2), and the duration of the treatment was 14 sessions (SD = 11.2). The percentage of discharges was 70.2%. The average cost of treatment was around €840. The results are discussed, underlining the value of empirically supported treatments for anxiety disorders.

Keywords

anxiety disordersclinical contexttreatmentstherapeutic results
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 18 , 2015 , E83
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2015 

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th Ed.). Washington, DC: Author.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th Ed., Rev.). Washington, DC: Author.Google Scholar
Arenas, M. C., & Puigcever, A. (2009). Diferencias entre hombres y mujeres en los trastornos de ansiedad: Una aproximación psicobiológica [Differences between men and women in the anxiety disorders: A psychobiological approach]. Escritos de Psicología, 3, 20–29.CrossRefGoogle Scholar
Bados, A., Balaguer, G., & Saldaña, C. (2007). Outcome of cognitive–behavioral therapy in training practice with anxiety disorder patients. British Journal of Clinical Psychology, 46, 429–435. http://dx.doi.org/10.1348%2F014466507X209961 CrossRefGoogle ScholarPubMed
Bayer, J. K., Hiscock, H., Ukoumunne, O. C., Price, A., & Wake, M. (2008). Early childhood aetiology of mental health problems: A longitudinal population-based study. Journal of Child Psychology and Psychiatry, 49, 1166–1174. http://dx.doi.org/10.1111%2Fj.1469-7610.2008.01943.x CrossRefGoogle ScholarPubMed
Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory manual. San Antonio, TX: Harcourt Brace and Company.Google Scholar
Beck, A. T., Steer, R. A., & Brown, G. K (1996). Manual for the Beck Depression Inventory – II. San Antonio, TX: Psychological Corporation Google Scholar
Bienvenu, O. J., Davydow, D. S., & Kendler, K. S. (2011). Psychiatric ‘diseases’ versus behavioral disorders and degree of genetic influence. Psychological Medicine, 41, 33–40. http://dx.doi.org/10.1017%2FS003329171000084X CrossRefGoogle ScholarPubMed
Bijl, R., Ravelli, A., & van Zessen, G. (1998). Prevalence of psychiatric disorder in the general population: Results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology, 33, 587–595. http://dx.doi.org/10.1007%2Fs001270050098 CrossRefGoogle ScholarPubMed
Caballero, L., Fernández-Liria, A., Ramos, J. A., Gil, A., Madrigal, M., Porras, A., … Agüera, L. F. (1999). Prevalencia de los trastornos psiquiátricos en atención primaria usando el cuestionario PRIME-MD® [Prevalence of psychiatric disorders in primary healthcare through the PRIME-MD® questionnaire]. Atención Primaria, 23, 275–279.Google Scholar
Canino, G. J., Bird, H. R., Shrout, P. E., Rubio-Stipec, M., Bravo, M., Martinez, R., … Guevara, L. M. (1987). The prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry, 44, 727–735. http://dx.doi.org/10.1001%2Farchpsyc.1987.01800200053008 CrossRefGoogle ScholarPubMed
Cano-Vindel, A., & Miguel-Tobal, J. J. (1999). Evaluación de la ansiedad desde un enfoque interactivo y multidimensional: El Inventario de Situaciones y Respuestas de Ansiedad (ISRA) [Evaluation of the anxiety from an interactive and multidimensional approach: The Inventory of Anxiety Situations and Answers (ISRA)]. Psicología Contemporánea, 6, 14–21.Google Scholar
Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090–1097. http://dx.doi.org/10.1037//0022-006X.52.6.1090 CrossRefGoogle ScholarPubMed
Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J., & Williams, C. (1985). The Mobility Inventory for Agoraphobia. Behaviour Research and Therapy, 23, 35–44. http://dx.doi.org/10.1016/0005-7967(85)90140-8 CrossRefGoogle ScholarPubMed
Chambless, D. L., & Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685–716. http://dx.doi.org/10.1146%2Fannurev.psych.52.1.685 CrossRefGoogle ScholarPubMed
Demertzis, K. H., & Craske, M. G. (2006). Anxiety in primary care. Current Psychiatry Reports, 8, 291–297. http://dx.doi.org/10.1007%2Fs11920-006-0065-4 CrossRefGoogle ScholarPubMed
Demyttenaere, K., Bonnewyn, A., Bruffaerts, R., De Girolamo, G., Gasquet, I. , Kovess., … Alonso, J. (2008). Clinical factors influencing the prescription of antidepressants and benzodiazepines: Results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Journal of Affective Disorder, 110, 84–93. http://dx.doi.org/10.1016%2Fj.jad.2008.01.011 CrossRefGoogle ScholarPubMed
Derogatis, L. R. (1994). SCL-90-R, Brief Symptom Inventory, and matching clinical rating scales. In Maruish, M. (Ed.), Psychological Testing, Treatment Planning, and Outcome Assessment. New York, NY: Erlbaum.Google Scholar
Derogatis, L. R. (2001). Cuestionario de 90 síntomas (SCL-90-R) [Questionnaire of 90 symptoms (SCL-90-R)]. Madrid, Spain: TEA Ediciones, S.A.Google Scholar
Durham, R. C., Chambers, J. A., MacDonald, R. R., Power, K. G., & Major, K. (2003). Does cognitive-behavioral therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials. Psychological Medicine, 33, 499–509. http://dx.doi.org/10.1017%2FS0033291702007079 CrossRefGoogle ScholarPubMed
Gaston, J. E., Abbott, M. J., Rapee, R. M., & Neary, S. A. (2006). Do empirically supported treatments generalize to private practice? A benchmark study of a cognitive-behavioral group treatment program for social phobia. British Journal of Clinical Psychology, 45, 33–48. http://dx.doi.org/10.1348%2F014466505X35146 CrossRefGoogle ScholarPubMed
Gould, R. A., Buckminster, S., Pollack, M. H., Otto, M. W., & Yap, L. (1997). Cognitive-behavioral and pharmacological treatment for social phobia: A meta-analysis. Clinical Psychology: Science and Practice, 4, 291–306. http://dx.doi.org/10.1111%2Fj.1468-2850.1997.tb00123.x Google Scholar
Hahlweg, K., Fiegenbaum, W., Frank, M., Schroeder, B., & von Witzleben, I. (2001). Short- and long-term effectiveness of an empirically supported treatment for agoraphobia. Journal of Consulting and Clinical Psychology, 69, 375–382. http://dx.doi.org/10.1037%2F0022-006X.69.3.375 CrossRefGoogle Scholar
Herrero, M., González, E., Valverde, T., & Caballero, L. (2001). Utilización del cuestionario PRIME-MD® para la detección de trastornos mentales en mujeres inmigrantes iberoamericanas e hispanohablantes [Use of Questionnaire PRIME-MD® for the detection of mental disorders in Spanish-speaking Latin American’s immigrants women]. Medicina Clínica, 117, 716–717. http://dx.doi.org/10.1016%2FS0025-7753%2801%2972232-4 CrossRefGoogle Scholar
Haro, J. M., Palacín, C., Vilagut, G., Martínez, M., Bernal, M., Luque, I., … Grupo ESEMeD-España (2006). Prevalencia de los trastornos mentales y factores asociados: Resultados del estudio ESEMeD-España [Prevalence of mental disorders and associate factors: Results of the ESEMeD-Spain study]. Medicina Clínica, 126, 445–451. http://dx.doi.org/10.1157%2F13086324 CrossRefGoogle Scholar
Hunsley, L., & Mash, E. J. (2008). A guide to assessments that work. New York, NY: Oxford University Press.CrossRefGoogle Scholar
Kendall, P. C., Hudson, J. L., Gosch, E., Flannery-Schroeder, E., & Suveg, C. (2008). Cognitive-behavioral therapy for anxiety disordered youth: A randomized clinical trial evaluating child and family modalities. Journal of Consulting and Clinical Psychology, 76, 282–297. http://dx.doi.org/10.1037%2F0022-006X.76.2.282 CrossRefGoogle ScholarPubMed
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627. http://dx.doi.org/10.1001%2Farchpsyc.62.6.617 CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R. L., Williams, J., Monahan, P. O., & Lowe, B. (2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146, 317–325. http://dx.doi.org/10.7326%2F0003-4819-146-5-200703060-00004 CrossRefGoogle ScholarPubMed
Labrador, F. J., & Ballesteros, F. (2011). Efectividad de los tratamientos para la fobia social en el ámbito aplicado [Effectiveness of the treatments for the social phobia in an applied field]. Psicothema, 23, 560–565.Google Scholar
Labrador, F. J., Estupiñá, F. J., & García-Vera, M. P. (2010). Demanda de atención psicológica en la práctica clínica [Psychological care demand in clinical practice: Treatment and results]. Psicothema, 22, 619–626.Google Scholar
Lincoln, T. M., Rief, W., Hahlweg, K, Frank, M, von Witzleben, I., Schroeder, B., & Fiegenbaum, W. (2003). Effectiveness of an empirically supported treatment for social phobia in the field. Behaviour Research and Therapy, 41, 1251–1269. http://dx.doi.org/10.1016%2FS0005-7967%2803%2900038-X CrossRefGoogle ScholarPubMed
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495. http://dx.doi.org/10.1016/0005-7967(90)90135-6 CrossRefGoogle ScholarPubMed
Millon, T. (1987). Millon Clinical Multiaxial Inventory-II manual. Minneapolis. MN: National Computer Systems.Google Scholar
Millon, T. (1998). MCMI-II. Inventario Clínico Multiaxial de Millon II. Manual [Millon Clinical Multiaxial Inventory II. Manual]. Madrid, Spain: TEA.Google Scholar
Ministerio de Sanidad y Consumo. (2006). Encuesta Nacional de Salud en España 2006 [National survey of Health in Spain 2006]. Madrid, Spain: Author.Google Scholar
Ministerio de Sanidad y Consumo (2007). Estrategia en salud mental del Sistema Nacional de Salud, 2006 [Strategy in mental health of the National Health System, 2006]. Madrid, Spain: Author.Google Scholar
Mitte, K. (2005) A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia. Journal of Affective Disorders 88, 27–45. http://dx.doi.org/10.1016%2Fj.jad.2005.05.003 CrossRefGoogle ScholarPubMed
Muñoz, M. (2008) Proceso de evaluación psicológica cognitivo – conductual: Una guía de actuación [Process of cognitive-behavioral psychological assessment: A performance guide]. In Labrador, , F. J. (Coord.), Técnicas de modificación de conducta [Techniques of behavior modification] (69–101). Madrid, Spain: Pirámide.Google Scholar
Otto, M. W., Pollack, M. H., & Maki, K. M. (2000). Empirically supported treatments for panic disorder: Costs, benefits, and stepped care. Journal of Consulting and Clinical Psychology, 68, 556–563. http://dx.doi.org/10.1037%2F%2F0022-006X.68.4.556 CrossRefGoogle ScholarPubMed
Otto, M. W., Smits, J. A. J., & Reese, H. E. (2005). Combined psychotherapy and pharmacotherapy for mood and anxiety disorders in adults: Review and analysis. Clinical Psychology: Science and Practice, 12, 72–86. http://dx.doi.org/10.1093%2Fclipsy.bpi009 Google Scholar
Rachman, S., & Hodgson, R. J. (1980) Obsessions and compulsions. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Regier, D. A., Rae, D. S., Narrow, W. E., Kaelber, C. T., & Schatzberg, A. F. (1998). Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. British Journal of Psychiatry, 173, 24–28.CrossRefGoogle Scholar
Rettew, D. C., Lynch, A. D., Achenbach, T. M., Dumenci, L., & Ivanova, M. Y. (2009). Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews. International Journal of Methods in Psychiatric Research, 18, 169–184. http://dx.doi.org/10.1002%2Fmpr.289 CrossRefGoogle ScholarPubMed
Sánchez- Meca, J., Rosa, A. I., & Olivares, J. (2004). El tratamiento de la fobia social específica y generalizada en Europa: Un estudio meta-analítico [The treatment of the specific and generalized social phobia in Europe: An metanalytical study ]. Anales de Psicología, 20, 55–68.Google Scholar
Somers, J. M., Goldner, E. M., Waraich, P., & Hsu, L. (2006). Prevalence and incidence studies of anxiety disorders: Review of the literature. Canadian Journal of Psychiatry, 51, 100–113.CrossRefGoogle ScholarPubMed
Spielberger, C. D., Gorsuch, R., & Lushene, R. (1970). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologist.Google Scholar
Spielberger, C. D., Gorsuch, R. L. & Lushene, R. E. (2008). STAI. Cuestionario de ansiedad estado-rasgo. [STAI. State-trait anxiety inventory] (7th Ed. Rev.). Madrid, Spain: TEA.Google Scholar
Valero, M., & Ruiz, M. A. (2003). Evaluación de un servicio de Salud Mental: Análisis de la demanda y datos epidemiológicos [Evaluation of a Mental Health service: Analysis of the demand and epidemiological data ]. Psiquis, 2, 11–18.Google Scholar
Vallejo, M. A., Jordán, C. M., Díaz, M. I., Comeche, M. I., Ortega, J., Amor, P., & Zubeidat, I. (2008). Perfil sociodemográfico de los usuarios de un servicio de asistencia psicológica online [Sociodemographic profile of the users of a service of psychological attendance online]. Psicothema, 20, 610–615.Google Scholar
van Ingen, D. J., Freiheit, S. R., & Vye, C. S. (2009). From the lab to the clinic: Effectiveness of cognitive–behavioral treatments for anxiety disorders. Professional Psychology: Research and Practice, 40, 69–74. http://dx.doi.org/10.1037%2Fa0013318 CrossRefGoogle Scholar
Wagner, R., Silove, D., Joukhador, J., Manicavasagar, V., Marnane, C., & Kirsten, L. T. (2005). Characteristics of the first 1000 clients attending an anxiety clinic in South West Sydney. Australian Journal of Psychology, 57, 180–185. http://dx.doi.org/10.1080%2F00049530500125207 CrossRefGoogle Scholar
Watson, D., & Friend, R. (1969). Measurement of social-evaluative anxiety. Journal of Consulting and Clinical Psychology, 33, 448–457. http://dx.doi.org/10.1037/h0027806 CrossRefGoogle ScholarPubMed
Yonkers, K. A., Bruce, S. E., Dyck, R. H., & Keller, M. B. (2003). Chronicity, relapse, and illness course of panic disorder, social phobia, and generalized anxiety disorder: Findings in men and women from 8 years of follow-up. Depression and Anxiety, 17, 173–179. http://dx.doi.org/10.1002%2Fda.10106 CrossRefGoogle ScholarPubMed