Psychotherapeutic intervention performed by specialized Mental Health nurses combined with pharmacotherapy is significantly more effective at reducing anxiety levels and promoting self-control in people with pathological anxiety than the treatment only with medication.

This is the conclusion of a study carried out by a group of researchers at CINTESIS/Nursing School of Porto (ESEP in Portuguese), including Francisco Sampaio (first author), Odete Araújo, Teresa Martins and Carlos Sequeira, that was published in the Journal of Advanced Nursing.

The study, conducted between 2016 and 2017, aimed to evaluate the effectiveness of the psychotherapeutic intervention of Nursing in Portuguese adults between 18 and 64 years of age suffering from anxiety, as a symptom, in pathological levels, comparing a group of people treated only with drugs and another group treated with drugs and with psychotherapeutic intervention.

The results indicate a “positive effect of the psychotherapeutic intervention of Nursing” performed by a nurse specialized in Mental Health, with a clear decrease in anxiety levels and an increase in anxiety self-control at the end of the five sessions (45 to 60 minutes / week) performed in five consecutive weeks.

“Individuals who received only pharmacotherapy improved their anxiety but did not improve their self-control, while those who received pharmacotherapy and psychotherapeutic intervention significantly improved anxiety levels and as well as anxiety self-control. This happens essentially because if individuals do not acquire strategies of self-control, they will not be able to cope with it without the use of drugs,” says Francisco Sampaio, who is completing his Ph.D. in Nursing Sciences at the Abel Salazar Institute of Biomedical Sciences of the University of Porto.

In this study, the psychotherapeutic intervention of Nursing was composed of a set of techniques, which could include, “among others, relaxation therapy, counseling, intervention in crisis and/or promotion of adaptive coping strategies.”

“These are data that reinforce the importance of using psychotherapeutic intervention as a complement to treatment and that can and should be presented to (political) decision makers as scientific evidence that justifies psychotherapeutic interventions as an autonomous practice in Mental Health Nursing,” says the author of the study.

The CINTESIS researcher, a nurse working at the Psychiatry Service of the Braga Hospital and a guest assistant lecturer at the Nursing School of Porto (ESEP), added that psychotherapeutic intervention should be included in Nursing education, so that nurses can systematize their practice on the ground in the near future.

Francisco Sampaio now hopes to continue investigating in this same line, applying the same model of intervention in people with other diagnoses in the area of Mental Health, such as deficit in impulse control or decrease in the will to live.

Data from 2013 indicate that Anxiety Disorders affect 16.5% of the Portuguese population. However, pathological anxiety, as a symptom, does not only exist in anxiety disorders but is very frequent, for example, in depression-related disorders, which, according to data of the same year, affect 7.9% of the Portuguese population. In fact, it is estimated that about a quarter of the population suffers from anxiety at pathological levels, a number that may be “underestimated.”

In 2016, 1.9 million Portuguese (one-fifth of the national population) purchased at least one pack of benzodiazepines (such as diazepam, alprazolam or lorazepam) and 800,000 took them daily (more than, for example, in Spain, Sweden or Italy).

The adverse effects of taking this type of drug include disturbances in balance, drowsiness and changes in vision, often associated with falls and road accidents. Long-term intake of this medication can cause effects such as alterations in memory and learning ability, as well as dependence.