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 of potentially hereditary illnesses that could affect the outcome measures, including schizophrenia, Alzheimer disease, and other cognitive disorders. This would have helped in understanding the patient population and generalizability of the findings, as well as the possibility of effect modification.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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