{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:42:55Z","timestamp":1775184175851,"version":"3.50.1"},"reference-count":55,"publisher":"Walter de Gruyter GmbH","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"Abstract<\/jats:title>\n \n Context<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate the efficacy of adjunctive osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) in individuals with GAD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n 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 \u226520) 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.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Significant reductions in total HAM-A scores after OMTh were observed (P<\/jats:italic><.0001). Significant reductions in total Intolerance for Uncertainty Scale scores were also observed (P<\/jats:italic><.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 \u22647) rates were found to be 62% and 26.9%, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Osteopathic manipulative therapy may be a valuable adjunct to conventional therapy in patients with GAD, thus warranting further investigation using double-blind procedures.<\/jats:p>\n <\/jats:sec>","DOI":"10.7556\/jaoa.2020.026","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T14:31:32Z","timestamp":1582554692000},"page":"133-143","source":"Crossref","is-referenced-by-count":14,"title":["Effect of Osteopathic Manipulative Therapy on Generalized Anxiety Disorder"],"prefix":"10.1515","volume":"120","author":[{"given":"Lindsay","family":"Dixon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Fotinos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilia","family":"Sherifi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachinthya","family":"Lokuge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexa","family":"Fine","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Furtado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leena","family":"Anand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine","family":"Liberatore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin A.","family":"Katzman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2020,3,1]]},"reference":[{"issue":"4","key":"2021040109395471186_j_jaoa.2020.026_ref_001_w2aab3b7c10b1b6b1ab2b1b1Aa","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1001\/jamapsychiatry.2014.2502","article-title":"Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis","volume":"72","year":"2015","journal-title":"JAMA Psychiatry"},{"issue":"suppl 1","key":"2021040109395471186_j_jaoa.2020.026_ref_002_w2aab3b7c10b1b6b1ab2b1b2Aa","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1186\/1471-244X-14-S1-S1","article-title":"Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders","volume":"14","year":"2014","journal-title":"BMC Psychiatry"},{"key":"2021040109395471186_j_jaoa.2020.026_ref_003_w2aab3b7c10b1b6b1ab2b1b3Aa","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1146\/annurev-clinpsy-050212-185544","article-title":"Worry and generalized anxiety disorder: a review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment","volume":"9","year":"2013","journal-title":"Annu Rev Clin Psychol"},{"issue":"9","key":"2021040109395471186_j_jaoa.2020.026_ref_004_w2aab3b7c10b1b6b1ab2b1b4Aa","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1002\/da.20674","article-title":"The relationship between anxiety disorders and suicide attempts: findings from the National Epidemiologic Survey on Alcohol and Related Conditions","volume":"27","year":"2010","journal-title":"Depress Anxiety"},{"issue":"2","key":"2021040109395471186_j_jaoa.2020.026_ref_005_w2aab3b7c10b1b6b1ab2b1b5Aa","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1016\/j.cpr.2014.01.002","article-title":"Psychological treatment of generalized anxiety disorder: a meta-analysis","volume":"34","year":"2014","journal-title":"Clin Psychol Rev"},{"issue":"3","key":"2021040109395471186_j_jaoa.2020.026_ref_006_w2aab3b7c10b1b6b1ab2b1b6Aa","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1016\/j.jad.2013.05.042","article-title":"Complementary and alternative therapies as add-on to pharmacotherapy for mood and anxiety disorders: a systematic review.","volume":"150","year":"2013","journal-title":"J Affect Disord."},{"issue":"1","key":"2021040109395471186_j_jaoa.2020.026_ref_007_w2aab3b7c10b1b6b1ab2b1b7Aa","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.explore.2009.10.004","article-title":"Top-down and bottom up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research","volume":"6","year":"2010","journal-title":"Explore"},{"key":"2021040109395471186_j_jaoa.2020.026_ref_008_w2aab3b7c10b1b6b1ab2b1b8Aa","volume-title":"Osteopathic philosophy. 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