Sustainability of Treatment Success 5 Years after Exposure-Based Cognitive-Behavioral Therapy for Anxiety Disorders

Research output: Contribution to journal › Research article › Contributed › peer-review

Contributors

  • Andre Pittig - , University of Göttingen (Author)
  • Ingmar Heinig - , Chair of Clinical Psychology and Behavioral Neuroscience (Author)
  • Volker Arolt - , University of Münster (Author)
  • Christina Bartnick - , Ruhr University Bochum (Author)
  • Udo Dannlowski - , University of Münster (Author)
  • Jürgen Deckert - , University of Würzburg (Author)
  • Katharina Domschke - , University Medical Center Freiburg, German Center for Mental Health (DZPG) (Author)
  • Thomas Fydrich - , Humboldt University of Berlin (Author)
  • Stephan Goerigk - , Ludwig Maximilian University of Munich, Fresenius University of Applied Sciences Idstein (Author)
  • Alfons O. Hamm - , University of Greifswald (Author)
  • Maike Hollandt - , University of Greifswald (Author)
  • Tilo Kircher - , University of Marburg (Author)
  • Katja Koelkebeck - , Bielefeld University (Author)
  • Ulrike Lueken - , German Center for Mental Health (DZPG), Humboldt University of Berlin (Author)
  • Jürgen Margraf - , Ruhr University Bochum (Author)
  • Peter Neudeck - , Prof. Dr. Peter Neudeck's Practice at the Volksgarten, Chemnitz University of Technology (Author)
  • Paul Pauli - , University of Würzburg (Author)
  • Jan Richter - , Fresenius University of Applied Sciences Idstein, University of Hildesheim (Author)
  • Isabelle Ridderbusch - , University of Marburg, Bielefeld University (Author)
  • Winfried Rief - , University of Marburg (Author)
  • Silvia Schneider - , Ruhr University Bochum (Author)
  • Benjamin Straube - , University of Greifswald (Author)
  • Andreas Ströhle - , Charité – Universitätsmedizin Berlin (Author)
  • Yunbo Yang - , University of Hildesheim (Author)
  • Hans Ulrich Wittchen - , Ludwig Maximilian University of Munich (Author)
  • Jürgen Hoyer - , Chair of Behavioral Psychotherapy (Author)

Abstract

Abstract – Introduction: Achieving sustainable success in the treatment of anxiety disorders remains a central objective in mental health care. Although research has demonstrated the short-term efficacy of psychotherapy, evidence regarding long-term sustainability is limited. This study examined treatment outcomes 5 years after prediction-error-based exposure therapy. Methods: For 355 patients (616 eligible; 58% follow-up rate), newly collected follow-up data on anxiety symptoms and psychosocial functioning were compared to pretreatment, posttreatment, and 6-month follow-up data from a multicenter clinical trial characterized by high treatment fidelity. Results: Improvements in anxiety symptoms and psychosocial functioning that were evident at posttreatment and 6-month follow-up were largely preserved after 5 years. No significant differences emerged between randomized groups of temporally intensified and non-intensified exposure. From 6 months to 5 years, overall remission rates remained stable, with the majority of patients exhibiting no reliable change in symptom severity. Reliable relapse occurred in 4.9% and reliable new remission in 6.5%. Most patients (63.4%) did not seek additional treatment. Among those who did, depression (64.2%) and anxiety (60.5%) were the most frequently cited reasons, although only a minority (6.0%) sought further treatment exclusively for anxiety. Additional treatment during the follow-up period was associated with higher symptom severity throughout assessments. Conclusion: These findings highlight the sustainability and long-term public health benefits of exposure-based CBT for anxiety disorders. Most patients do not need additional treatments for mental disorders even 5 years after treatment. Nevertheless, further efforts are needed to optimize interventions for those patients who do not achieve remission or experience relapse.

Details

Original languageEnglish
Number of pages12
JournalPsychotherapy and psychosomatics
Publication statusE-pub ahead of print - 24 Nov 2025
Peer-reviewedYes

External IDs

PubMed 41284592
ORCID /0000-0002-1697-6732/work/219975251
ORCID /0000-0002-7762-4327/work/219976099

Keywords

Sustainable Development Goals

Keywords

  • Anxiety disorders, Exposure therapy, Long-term treatment outcome