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Psychotherapies for Panic Disorder: A Tale of Two Sites
The Journal of Clinical Psychiatry
|July 28, 2016
Summary
Cognitive-behavioral therapy (CBT) and panic-focused psychodynamic psychotherapy (PFPP) demonstrated consistent effectiveness for panic disorder. Applied relaxation training (ART) showed lower patient acceptance, especially for severe cases.
Area of Science:
- Psychiatry
- Clinical Psychology
- Psychotherapy Research
Background:
- Panic disorder is a debilitating condition often treated with various psychotherapeutic modalities.
- Cognitive-behavioral therapy (CBT), panic-focused psychodynamic psychotherapy (PFPP), and applied relaxation training (ART) are established treatments for panic disorder.
Purpose of the Study:
- To compare the efficacy and patient acceptance of CBT, PFPP, and ART in treating DSM-IV panic disorder with or without agoraphobia.
- To investigate potential site-by-treatment interactions in treatment outcomes.
Main Methods:
- A 2-site randomized controlled trial involving 201 patients with panic disorder.
- Patients were randomized to receive 19-24 sessions of CBT, PFPP, or ART over 12 weeks, with medication held constant.
- Attrition rates and treatment response (40% reduction in Panic Disorder Severity Scale) were assessed.
Main Results:
- Attrition rates were highest for ART (41%), followed by CBT (25%) and PFPP (22%).
- Significant site-by-treatment interactions were observed for the speed of symptom improvement and treatment response.
- While CBT showed consistent performance across sites, PFPP also showed promise, particularly at one site.
Conclusions:
- All three treatments improved panic disorder symptoms, but ART was less acceptable to patients, especially those with severe illness.
- CBT demonstrated the most consistent results across both study sites.
- PFPP emerged as a promising psychodynamic approach for treating panic disorder.
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