There are currently various research gaps in the field of psychotherapeutic treatment of anxiety disorders:
Lack of efficacy studies on the treatment of patients with anxiety disorders with systematic consideration of the high comorbidity in this group of disorders
Lack of studies examining the sustainability of the effects of anxiety treatments
Lack of investigation of the long-term cost-benefit ratio of anxiety treatments.
The APS study seeks to close these gaps through a randomized controlled study design, comparing two treatment methods for patients with anxiety disorders and comorbidity in personality difficulties. The study aims to evaluate the effectiveness, sustainability of achieved changes, and the long-term cost-benefit ratio of the two treatment modalities: analytical psychotherapy and cognitive-behavioral therapy.
The study will include a total of 260 patients, with 130 assigned to each treatment method. The research will be conducted across four distinct study centers located in Berlin, Hamburg, Heidelberg, Kassel, and Munich. Participation in psychopharmacological treatment is not an exclusion criterion, except for the long-term use of benzodiazepines. All psychiatric interventions, including medication and inpatient treatment, will be documented and subsequently considered as covariates in the statistical analysis.
The hypotheses assume that both behavioral therapy and analytical psychotherapy yield notable improvements (benefit criterion). However, it is anticipated that the enhancements in patients undergoing analytical psychotherapy will demonstrate greater long-term stability in follow-up assessments (uniformly conducted six years after treatment initiation, irrespective of the treatment form). This expectation is based on the significantly higher treatment dosage, particularly for patients with multiple comorbidities (necessity criterion). Furthermore, it is assumed that the two psychotherapy approaches will exhibit comparable cost-benefit ratios in the long-term follow-up assessments (cost-effectiveness criterion).
Total duration: 12 years
Addressing the question of the long-term effects of long-term treatments inherently necessitates an extended timeframe. The recruitment phase for the 260 study participants is envisioned to span multiple years. The protracted follow-up intervals arise from the extended durations of the long-term treatments, estimated here to be approximately three years for analytical psychotherapy, and the inclusion of at least three annual follow-up assessments (or a final survey six years post-treatment initiation for all interventions). Regardless of the specific durations of individual treatments, the overall observation period extends to six years from the commencement of treatment. The persistence of follow-up assessments, even for briefer treatments, holds particular significance for evaluating cost-effectiveness. This approach is crucial for facilitating a realistic comparison of cost-benefit ratios.
Original Language: German