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Panic Disorder in Primary Care.

Jochen Gensichen1,2,3, Thomas S Hiller2,3, Jörg Breitbart2

  • 1Institute of General Practice and Family Medicine, University Hospital of the Ludwig-Maximilians University of Munich, Munich, Germany

Deutsches Arzteblatt International
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Summary
This summary is machine-generated.

A team-based exercise program significantly improved panic disorder symptoms in primary care patients. This intervention, combined with case management, offered greater symptom relief than standard treatment.

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Area of Science:

  • Psychiatry
  • Primary Care Medicine
  • Behavioral Health

Background:

  • Panic disorder with or without agoraphobia (PDA) is a prevalent condition managed in primary care settings.
  • Evaluating accessible, non-pharmacological interventions for PDA is crucial for improving patient outcomes.
  • Team-based exercise programs offer a potential avenue for managing anxiety disorders within primary care.

Purpose of the Study:

  • To assess the efficacy of a team-based exercise program combined with case management for patients with panic disorder with or without agoraphobia (PDA).
  • To compare the outcomes of this intervention against standard care in a primary care setting.
  • To evaluate the impact on anxiety symptoms, panic attack frequency, avoidant behavior, and quality of treatment.

Main Methods:

  • A cluster-randomized, controlled intervention trial involving 419 patients with PDA across 73 primary care practices.
  • Patients were assigned to either a 23-week team-based exercise program with case management or standard care.
  • Primary endpoint was anxiety symptom reduction measured by the Beck Anxiety Inventory (BAI) at six months, with follow-up at twelve months.

Main Results:

  • The intervention group showed significantly greater improvement in anxiety symptoms compared to the control group (p = 0.008).
  • The reduction in BAI scores was 3.0 points at six months and 4.0 points at twelve months in favor of the intervention group.
  • Significant reductions in panic attack frequency, avoidant behavior, and depressiveness were observed in the intervention group, along with improved treatment quality.

Conclusions:

  • A team-based exercise program integrated with case management is an effective strategy for managing panic disorder with or without agoraphobia in primary care.
  • This intervention demonstrates superior outcomes in reducing anxiety symptoms and related impairments compared to standard care.
  • The findings support the implementation of such programs to enhance mental health treatment within primary care settings.