Cognitive behavioral therapy for frequent attenders in primary care

Aim: The aim of the study is to investigate if cognitive behavioral therapy given in agroup setting affects anxiety and depression, stress, pain, coping strategies duringdaily 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 and65 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 therapyconsisted of 12 sessions administered in group format. Outcome measures wereBeck's Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), Hospital Anxietyand Depression Scale (HADS), Everyday Life Stress (ELS), Coping Strategy Question-naire, Multidimensional Pain Inventory‐Swedish version, and Short Form‐36. Results: Mean age among patients who completed cognitive behavioral therapywas 49.9 years, with a female majority (79.6%). Anxiety and depression scores werereduced after treatment (BAI 16.7 vs 13.6; BDI 16.3 vs 15.7; HADS‐Anxiety 8.41 vs6.05; HADS‐Depression 7.09 vs 5.69). Because waiting time itself did not affectsymptoms, differences reflect treatment effects. Stress ratings were not affected bytreatment. Use of nonadaptive coping strategies likepraying and hopingandcatastrophizingdecreased. Frequent attenders experienced a higher sense of lifecontrol. Frequent attenders reported significantly lower HRQoL than general Swedishpopulation norms in all 8 Short Form‐36 domains including mental and physicalcomponent summary scores (MCS and PCS), and all domains were unaffected bytreatment. 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 painbecause of enhanced life control