Abstract
Background: Psychotherapy and pharmacotherapy are both effective in the treatment of anxiety disorders. However, drugs in pharmacotherapy are often compared with placebo controls, and psychotherapy is mostly compared to patients in the waiting list as the controls. We aimed to compare the effects of analytic group therapy with pharmacotherapy in patients with anxiety disorders.
 Methods: In this clinical trial study in Tehran, 65 patients (10 males, 55 females) presenting with a primary diagnosis of panic disorder, generalized anxiety disorder, and/or mixed anxiety-depressive disorder (based on a structured clinical interview by a psychiatrist) were enlisted during the period from 2016 to 2018. The patients were randomly divided into two groups: drug therapy (group D, 33 patients), or drug therapy + analytic group therapy (group G, 32 patients). Anxiety was assessed in both groups before and immediately after treatment by the Persian version of the Hamilton Anxiety scale (HAM-A). Collected data were analyzed by SPSS statistical software version 21.
 Results: Both groups showed a statistically significant decline in HAM-A scores after the treatment. However, group G had a greater significant change in anxiety score compared to group D. The mean decline of HAM-A was 25.694.82 for group G and 23.214.64 for group D. The HAM-A score was significantly reduced in group G compared to group D (p = 0.039).
 Conclusion: This study showed that psychodynamic psychotherapy could improve the pharmacotherapy effects and is superior to pharmacotherapy alone.
Highlights
Anxiety disorders are known as the most common psychiatric disorders in the general population that often have a substantial impact on a person’s daily life 1–3, and are associated with different comorbidities 4–6
We aimed to compare the effects of analytic group therapy with pharmacotherapy in patients with anxiety disorders
This study showed that psychodynamic psychotherapy could improve the pharmacotherapy effects and is superior to pharmacotherapy alone
Summary
Anxiety disorders are known as the most common psychiatric disorders in the general population that often have a substantial impact on a person’s daily life 1–3, and are associated with different comorbidities 4–6. Most patients with anxiety disorders who seek help are suffering from generalized anxiety disorder (GAD), pathological demand avoidance (PDA), and seasonal affective disorder (SAD) 10. Their treatment can be performed most of the time in an outpatient setting 11. Psychotherapy and pharmacotherapy are both effective in the treatment of anxiety disorders. We aimed to compare the effects of analytic group therapy with pharmacotherapy in patients with anxiety disorders. Results: Both groups showed a statistically significant decline in HAM-A scores after the treatment.
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