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Cognitive behavioral therapy for frequent attenders in primary care
Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden; Department of Psychology, Uppsala University, Uppsala, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.
Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Psychology, Uppsala University, Uppsala, Sweden.
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2018 (English)In: Health science reports, ISSN 2398-8835, Vol. 1, no 9, article id e80Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the study is to investigate if cognitive behavioral therapy given in a group setting affects anxiety and depression, stress, pain, coping strategies during daily life, and health-related quality of life (HRQoL), among frequent attenders (FAs) in primary care.

Methods: Cognitive behavioral therapy was offered to 331 FAs between 18 and 65 years of age, of whom 89 accepted and 54 completed all steps in the protocol; patients were assigned to 1 of 3 groups: 0, 6, and 12-month waiting time. The therapy consisted of 12 sessions administered in group format. Outcome measures were Beck's Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Everyday Life Stress (ELS), Coping Strategy Questionnaire, Multidimensional Pain Inventory-Swedish version, and Short Form-36.

Results: Mean age among patients who completed cognitive behavioral therapy was 49.9 years, with a female majority (79.6%). Anxiety and depression scores were reduced after treatment (BAI 16.7 vs 13.6; BDI 16.3 vs 15.7; HADS-Anxiety 8.41 vs 6.05; HADS-Depression 7.09 vs 5.69). Because waiting time itself did not affect symptoms, differences reflect treatment effects. Stress ratings were not affected by treatment. Use of nonadaptive coping strategies like praying and hoping and catastrophizing decreased. Frequent attenders experienced a higher sense of life control. Frequent attenders reported significantly lower HRQoL than general Swedish population norms in all 8 Short Form-36 domains including mental and physical component summary scores (MCS and PCS), and all domains were unaffected by treatment.

Conclusion: Cognitive behavioral therapy exerts some beneficial effects in FAs. Content of treatment addressed musculoskeletal pain, stress, anxiety, and depression. This broad approach resulted in reduced anxiety, depression, and impact of pain because of enhanced life control.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 1, no 9, article id e80
Keywords [en]
Sweden, applied relaxation, cognitive behavioral therapy, frequent attender, primary care, quality of life
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:oru:diva-73679DOI: 10.1002/hsr2.80PubMedID: 30623103OAI: oai:DiVA.org:oru-73679DiVA, id: diva2:1304477
Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-04-12Bibliographically approved

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Karlsson, Jan

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Citation style
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