Exposure Therapy for Late-life Anxiety

Summary

The primary objective is to evaluate the (cost-)effectiveness of exposure therapy (ET) delivered by trained mental health nurses (MHNs) in terms of anxiety symptoms and quality of life for late life anxiety disorders in primary care compared to usual care (UC). UC is not restricted, and the general practitioner (GP) is encouraged to work according to the guidelines of the Dutch College of GPs. Participants in the ET group will receive 30-minute ET sessions delivered by a trained mental health nurse, during 8 sessions within the span of 12 weeks. Participants will fill in questionnaires before, during and after treatment, with a 1-year follow-up. The main study parameters are anxiety severity, quality of life and societal costs.

Eligibility

Inclusion Criteria:

* A primary DSM-5 anxiety disorder using the Mini Internationaal Neuropsychiatrisch Interview (MINI).
* One of the following DSM-5 anxiety disorders will be diagnosed, Generalized Anxiety Disorder, Agoraphobia, Panic Disorder or Social Anxiety Disorder.
* Participants are required to be sufficient in Dutch.

Exclusion Criteria:

* Exclusion criteria include somatic and/or another psychiatric morbidity that could interfere with diagnosing or treatment.
* Moderate to severe suicidality, which will be determined using the MINI
* Chronic and interfering substance or alcohol abuse
* Having received previous psychotherapy including exposure in the past year. -
* Antidepressants and benzodiazepines use are allowed if on a stable dose for a minimum of 8 weeks.
* Participants will be excluded if they score lower than 18 points on the MoCa (115). A score of \<18 is indicative for moderate to severe cognitive impairment. - Participants will be excluded if they are terminally ill.

Conditions4

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