- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02690441
Physical Exercise Augmented CBT for GAD (PEXACOG)
Physical Exercise Augmented Cognitive Behaviour Therapy for Older Adults With Generalised Anxiety Disorder
Generalised anxiety disorder (GAD) is a severe and debilitating anxiety disorder that is highly prevalent among older adults. Anxiety and GAD is a well-documented risk factor for the development of other severe conditions such as depression and dementia, and effective treatments are called for. However, recommended treatment for GAD has consistently been found to yield blunted response rates for older adults compared to younger patients.
The purpose of this study is to evaluate the effects of exercise-augmented cognitive behaviour therapy for older adults with GAD. Exercise augmented CBT is expected to yield better results than standard CBT in terms of greater reduction of symptoms and increased rates of remission. The investigators will also investigate the effects of treatment on biological, physiological and neuropsychological measures.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Nesttun
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Bergen, Nesttun, Norway, 5228
- Solli DPS
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Primary diagnosis of GAD
Exclusion Criteria:
- Substance abuse
- Use of benzodiazepines, use of antipsychotica
- Lack of ability to stabilize other psychotropic medication during participating in the study
- Medical condition that precludes participation in physical exercise
- Severe major depression as determined by the MINI International Neuropsychiatric Interview
- Life-time history of psychosis and/or mania
- Participation in other ongoing psychotherapy
- Organic brain disease
- Positive screening for dementia with Mini Mental State Examination
- Currently engaged in a regular physical exercise program
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: CBT augmented with physical exercise
Patients receive 10 sessions of cognitive behavioural therapy for generalized anxiety disorder.
Patients also receive 5 weeks of physical exercise pre-treatment, and 10 weeks of physical exercise alongside CBT.
Both treatment and physical exercise is administered individually.
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Cognitive behavioural therapy conducted individually.
10 weekly sessions, first session lasts 90 minutes, the remaining sessions last 45 minutes.
Manualised exercise.
15 weekly sessions with instructor, and two weekly unsupervised sessions performed individually.
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Active Comparator: CBT and placebo control
Patients receive 10 sessions of cognitive behavioural therapy for generalized anxiety disorder.
Patients also receive 5 weeks of placebo control (15 minutes telephone follow-up call each week) pre-treatment, and 10 weeks of attention placebo alongside CBT.
Both treatment and placebo control is administered individually.
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Cognitive behavioural therapy conducted individually.
10 weekly sessions, first session lasts 90 minutes, the remaining sessions last 45 minutes.
One follow-up telephone call à 15 minutes each week for 15 weeks.
Aims to control for therapist contact in physical exercise condition and total duration of treatment.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in The Penn State Worry Questionnaire
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Assesses symptom severity of GAD
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Change in clinical diagnosis after treatment assessed by independent, blinded rater with Anxiety Disorders Interview Schedule (ADIS-IV)
Time Frame: Baseline and post-treatment (up to 20 weeks after baseline)
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Remission rates.
Assessed by independent, blinded rater with Anxiety Disorders Interview Schedule (ADIS-IV)
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Baseline and post-treatment (up to 20 weeks after baseline)
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Geriatric Anxiety Inventory
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Generalized Anxiety Disorder 7-item scale (GAD-7)
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Beck Anxiety Inventory
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Beck Depression Inventory - II
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Bergen Insomnia Scale
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Quality of Life Inventory
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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International Physical Activity Questionnaire (IPAQ)
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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5-item Treatment Credibility and Expectancy Scale (CES)
Time Frame: Baseline
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Baseline
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Function and structure of prefrontal lobes and limbic system
Time Frame: Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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Functional Magnetic Resonance Imaging (fMRI) conducted with a 3-Tesla scanner.
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Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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Blood samples
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Serum concentrations of mature and pro brain-derived neurotropic factor
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Saliva samples
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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To measure cortisol
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Three subtests from Delis-Kaplan Executive Function System battery (D-KEFS; Delis, Kaplan & Kramer, 2001)
Time Frame: Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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Measures executive function
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Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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Wisconsin Card Sorting Test: Computer Version 4 research edition (WCST-CV4; Heaton, PAR staff & Goldin 2003).
Time Frame: Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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Measures executive function
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Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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The California Verbal Learning Test (CVLT; Delis, Kramer & Kaplan, 1994).
Time Frame: Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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Measures memory
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Baseline, post-treatment (up to 20 weeks after baseline) and 12 months follow-up
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Wechsler Abbreviated Scale of Intelligence
Time Frame: Baseline
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Two subtests from Wechsler Abbreviated Scale of Intelligence (WASI; Wechsler, 1999) will be administered to assess IQ level.
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Baseline
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Ambulatory Electrocardiogram (ECG)
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Measures heart rate variability (HRV)
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Ekblom-Bak submaximal ergometer cycle test
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Test for prediction of VO2 max, which gives an indication of physical fitness
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Strength test battery
Time Frame: Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Measures submaximal physical strength, which gives an indication of physical fitness.
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Baseline, after pre-treatment (up to 8 weeks after baseline), post-treatment (up to 20 weeks after baseline), 6 months follow-up and 12 months follow-up
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Anders Hovland, PhD, Solli DPS, University of Bergen
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 971427272T1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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