Archives of general psychiatry
-
Arch. Gen. Psychiatry · Dec 2009
Randomized Controlled Trial Comparative StudyClinical effectiveness of individual cognitive behavioral therapy for depressed older people in primary care: a randomized controlled trial.
In older people, depressive symptoms are common, psychological adjustment to aging is complex, and associated chronic physical illness limits the use of antidepressants. Despite this, older people are rarely offered psychological interventions, and only 3 randomized controlled trials of individual cognitive behavioral therapy (CBT) in a primary care setting have been published. ⋯ Cognitive behavioral therapy is an effective treatment for older people with depressive disorder and appears to be associated with its specific effects.
-
Arch. Gen. Psychiatry · Dec 2009
Comparative StudyDisrupted amygdalar subregion functional connectivity and evidence of a compensatory network in generalized anxiety disorder.
Little is known about the neural abnormalities underlying generalized anxiety disorder (GAD). Studies in other anxiety disorders have implicated the amygdala, but work in GAD has yielded conflicting results. The amygdala is composed of distinct subregions that interact with dissociable brain networks, which have been studied only in experimental animals. A functional connectivity approach at the subregional level may therefore yield novel insights into GAD. ⋯ Our findings provide new insights into the functional neuroanatomy of the human amygdala and converge with connectivity studies in experimental animals. In GAD, we find evidence of an intra-amygdalar abnormality and engagement of a compensatory frontoparietal executive control network, consistent with cognitive theories of GAD.