Original Contribution  |   March 2020
Effect of Osteopathic Manipulative Therapy on Generalized Anxiety Disorder
Author Notes
  • From the S.T.A.R.T. Clinic for Mood and Anxiety Disorders in Toronto, Ontario (Mss Dixon, Fotinos, Sherifi, Fine, Furtado, and Anand, Mr Lokuge, and Dr Katzman); the Department of Psychology at Lakehead University in Thunder Bay, Ontario (Dr Katzman); the Northern Ontario School of Medicine in Sudbury (Dr Katzman); the Department of Psychology at the Adler Graduate Professional School in Toronto, Ontario (Dr Katzman); and the Canadian College of Osteopathy in North York, Ontario (Ms Dixon and Ms Liberatore).  
  • Financial Disclosures: None reported.  
  • Support: None reported.  
  •  *Address correspondence to Martin A Katzman, MD, S.T.A.R.T. Clinic for Mood and Anxiety Disorders, 32 Park Rd, Toronto, Ontario, Canada M4W 2N4. Email: mkatzman@startclinic.ca
     
Article Information
Osteopathic Manipulative Treatment / Psychiatry
Original Contribution   |   March 2020
Effect of Osteopathic Manipulative Therapy on Generalized Anxiety Disorder
The Journal of the American Osteopathic Association, March 2020, Vol. 120, 133-143. doi:https://doi.org/10.7556/jaoa.2020.026
The Journal of the American Osteopathic Association, March 2020, Vol. 120, 133-143. doi:https://doi.org/10.7556/jaoa.2020.026
Abstract

Context: Traditional management options for generalized anxiety disorder (GAD) have produced low remission rates. As a result, the medical community has turned to complementary and alternative medicine for adjunctive treatment.

Objective: To investigate the efficacy of adjunctive osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) in individuals with GAD.

Methods: This open-label, nonrandomized, black-box study took place at a tertiary care mental health clinic in Toronto, Canada. Adult outpatient participants aged 18 to 65 years with a primary diagnosis of moderate-severe GAD (HAM-A score of ≥20) with or without comorbidities were enrolled in the study between June 2014 and January 2015. Patients who qualified and completed the study received 5 individually tailored OMTh sessions over the course of 8 to 9 weeks. A diagnostic psychiatric assessment (Mini International Neuropsychiatric Interview version 6.0.0) was conducted to confirm diagnoses, along with physician-administered and self-reported measures of anxiety, including the Hamilton Anxiety Scale (HAM-A), the Beck Anxiety Inventory, and the Intolerance for Uncertainty Scale.

Results: Significant reductions in total HAM-A scores after OMTh were observed (P<.0001). Significant reductions in total Intolerance for Uncertainty Scale scores were also observed (P<.0001). Beck Anxiety Inventory scores were not found to change significantly with OMTh. Response (defined as 50% reduction of symptoms) and remission (defined as HAM-A score of ≤7) rates were found to be 62% and 26.9%, respectively.

Conclusion: Osteopathic manipulative therapy may be a valuable adjunct to conventional therapy in patients with GAD, thus warranting further investigation using double-blind procedures.

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