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To the Editor: In their randomized controlled trial, Dr Stanley and colleagues¹ showed that older patients with generalized anxiety disorder who received cognitive behavior therapy (CBT) had greater improvements in worry severity, depressive symptoms, and general mental health than those who received enhanced usual care (EUC). Because of several important factors that were not included in the analyses, we have some concerns about the interpretation of these findings.

First, there was no information provided about the socioeconomic status of the patients beyond years of education. It is possible that the effectiveness of CBT would vary by socioeconomic status, and this could be assessed by subgroup analysis, statistical adjustment, or tests of interaction.

Second, treatment effectiveness may be different depending on whether the patient lives alone or with someone else. This does not appear to have been addressed in the analyses.

Third, the study did not provide information about family history . . . [Full Text of this Article]

Suning Chen, PharmB; Aidong Wen, PharmD; Jian Zhang, MD, PhD
biozhangj@yahoo.com.cn
Department of Pharmacy
Fourth Military Medical University
Xi’an, China

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