Benzodiazépines et thérapie cognitive-comportementale transdiagnostique de groupe pour les troubles anxieux : une étude mixte

Introduction: Cognitive-behavioural therapy (CBT) is known to be effective in the treatment of anxiety disorders, one of the most common mental health disorders. Benzodiazepines are also commonly used but should be prescribed as a second-line treatment, in the short term, and as an adjuvant to an evidence-based treatment. When starting CBT, it is frequent for people living with an anxiety disorder to already use a pharmacological treatment, including benzodiazepines. However, the effect of combining benzodiazepines with CBT is unclear. Objective: This study has two main objectives: (a) to explore the influence of pretreatment benzodiazepines use on the association between group transdiagnostic cognitive behavioural therapy (tCBT) and the reduction of anxiety symptoms; (b) to explore the participants' perception of their use of benzodiazepines before, during and after group tCBT. Methods: This convergent mixed design study was embedded in a pragmatic randomized controlled trial aiming to assess the effectiveness of a 12-week group tCBT for anxiety disorders as a complement to treatment-as-usual (TAU). The experimental arm received tCBT and TAU (n=117) while the control arm received TAU (n=114). Assessment of anxiety symptoms was obtained before and after treatment with the Beck Anxiety Inventory. A multiple linear regression analysis examined the interaction effect (arm*benzodiazepine) on anxiety symptom reduction. Thirteen qualitative interviews were done with a subsample of participants who received tCBT and used benzodiazepines in the 12 months prior to treatment initiation. Data were analyzed using an interpretive descriptive method. Results: The quantitative component of the study illustrated a non-differential effect of benzodiazepine use on the association between tCBT and anxiety symptom reduction (p>0.05). Qualitative findings brought nuance and depth to the utility of benzodiazepines during tCBT. Despite some benefits, participants raised the point that benzodiazepines may have interfered with the effectiveness of exposure exercises, since they modify anxiety experience. They may also have affected the acquisition of certain concepts, such as those seen in psychoeducation, due to the sedative effects of this medication. Conclusion: In addition to a global understanding, this study highlights the perceptions of people regarding their use of benzodiazepines during group tCBT, but also their experience with this medication, the premises of CBT intervention and the influence of group therapy.

Name thesis:degree_name

M. Sc.

Level thesis:degree_level

Maîtrise

Discipline thesis:degree_discipline

Sciences cliniques

Grantor dc:publisher

Université de Sherbrooke

Year dc:date.issued

2021

Author dc:creator

• Durand, Camila

Advisors dc:contributor.advisor

• Roberge, Pasquale
• Dubois, Marie-France

• Benzodiazépines
• Thérapie cognitive-comportementale
• TCC
• Psychothérapie de groupe
• Troubles anxieux
• Transdiagnostique
• Benzodiazepines
• Cognitive-behavior therapy
• CBT
• Group psychotherapy
• Anxiety disorders
• Transdiagnostic

Language dc:language.iso

fr, en

Handle dc:identifier.uri

http://hdl.handle.net/11143/18485

OAI identifier oai:identifier

oai:usherbrooke.scholaris.ca:11143/18485