Journal of International Psychiatry

[Abstract] Objective To explore the application of cognitive behavioral therapy combined with mirtazapine in patients with generalized anxiety disorder who have ineffective selective 5-hydroxytryptamine reuptake inhibitors (SSRIs)..Methods One hundred and twenty patients with generalized anxiety disorder who were treated at our hospital between June 2020 and January 2023 with ineffective SSRIs were retrospectively selected as study subjects and grouped according to different treatment protocols, with 60 cases in each group. The control group was treated with mirtazapine and the observation group was treated with cognitive behavioural therapy combined with mirtazapine. The clinical efficacy, psychiatric symptoms [the generalized anxiety disorder 7-item scale, (GAD-7)],, neuroendocrine hormones [thyroxine (T4), adrenocorticotropic hormone (ACTH), triiodothyronine (T3), thyrotropin (TSH)],and missed work time changes.Results The total effective rate of observation group was 95.00% (57/60) higher than that of control group 83.33% (50/60) (P < 0.05). After treatment, the GAD-7 scores in the observation group were lower than those in the control group; After treatment, the serum TSH and ACTH levels in the observation group were lower than those in the control group (P< 0.05). There were no significant differences in T3 and T4 levels between the two groups after treatment compared with before treatment and between the two groups after treatment (P> 0.05). After treatment, the observation group had shorter work-related delays than the control group (P < 0.05).Conclusion Cognitive behavioral therapy combined with Mirtazapine is effective in the treatment of patients with generalized anxiety disorder who do not respond to SSRIs. It can improve the psychiatric symptoms and cognitive function, regulate neuroendocrine hormones, and reduce the time lost from work.

[Key words]cognitive behavioral therapy; Generalized anxiety disorder; Neuroendocrine hormone; Psychiatric symptom