Screening for and Managing the Person with Frailty in Primary Care: ICFSR Consensus Guidelines

J. G. Ruiz, E. Dent, John E. Morley, R. A. Merchant, J. Beilby, J. Beard, C. Tripathy, M. Sorin, S. Andrieu, I. Aprahamian, H. Arai, M. Aubertin-Leheudre, J. M. Bauer, M. Cesari, L. K. Chen, A. J. Cruz-Jentoft, P. De Souto Barreto, B. Dong, L. Ferrucci, R. FieldingL. Flicker, J. Lundy, J. Y. Reginster, L. Rodriguez-Mañas, Y. Rolland, A. M. Sanford, A. J. Sinclair, J. Viña, D. L. Waters, C. Won Won, J. Woo, B. Vellas

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67 Citations (Scopus)



Cognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.

A randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.

Intention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated severity [1-month OR = 1.45 (0.45, 4.62), p = 0.53; 6-month OR = 1.31 (0.42, 4.08), p = 0.65], SAD remission (1-month: IE = 61.04%, VB = 55.09%, p = 0.59); 6-month: IE = 58.73%, VB = 61.89%, p = 0.77), or secondary outcomes. Three adverse events were noted (substance abuse, n = 1 in IE-CBT; temporary increase in suicide risk, n = 1 in each condition, with one being withdrawn at 1-month follow-up).

Group IE-CBT and VB-CBT were safe and there were no significant differences in outcomes. Both treatments were associated with very large within-group effect sizes and the majority of patients remitted following treatment.
Original languageEnglish
JournalJournal of Nutrition, Health and Aging
Publication statusPublished - 17 Oct 2020


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