A randomized trial of sertraline, self-administered cognitive behavior therapy, and their combination for panic disorder

BackgroundSelf-administered cognitive behavior therapy (SCBT) has been shown to be an effective alternative to therapist-delivered treatment for panic disorder (PD). However, it is unknown whether combining SCBT and antidepressants can improve treatment. This trial evaluated the efficacy of SCBT and sertraline, alone or in combination, in PD.MethodPatients (n=251) were randomized to 12 weeks of either placebo drug, placebo drug plus SCBT, sertraline, or sertraline plus SCBT. Those who improved after 12 weeks of acute treatment received treatment for an additional 12 weeks. Outcome measures included core PD symptoms (panic attacks, anticipatory anxiety, agoraphobic avoidance), dysfunctional cognitions (fear of bodily sensations, agoraphobic cognitions), disability, and clinical global impression of severity and improvement. Efficacy data were analyzed using general and generalized linear mixed models.ResultsPrimary analyses of trends over time revealed that sertraline/SCBT produced a significantly greater rate of decline in fear of bodily sensations compared to sertraline, placebo/SCBT and placebo. Trends in other outcomes were not significantly different over time. Secondary analyses of mean scores at week 12 revealed that sertraline/SCBT fared better on several outcomes than placebo, with improvement being maintained at the end of continuation treatment. Outcome did not differ between placebo and either sertraline monotherapy or placebo/SCBT. Moreover, few differences emerged between the active interventions.ConclusionsThis trial suggests that sertraline combined with SCBT may be an effective treatment for PD. The study could not confirm the efficacy of sertraline monotherapy or SCBT without concomitant medication or therapist assistance in the treatment of PD.

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The Generalizability of Cognitive Behavior Therapy for Panic Disorder

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.12.4.323 ◽

1998 ◽

Vol 12 (4) ◽

pp. 323-330 ◽

Cited By ~ 19

Author(s):

William C. Sanderson ◽

Patrick J. Raue ◽

Scott Wetzler

Keyword(s):

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Clinical Setting ◽

Ethnically Diverse ◽

Panic Attacks ◽

Controlled Clinical Trial ◽

Clinical Settings ◽

Cognitive Behavior ◽

Full Spectrum

The current study examined the generalizability of manual-driven cognitive-behavior therapy (CBT) for panic disorder to a clinical setting representing an ethnically diverse population. This treatment had previously been shown to be effective in a controlled clinical trial at a research clinic (Barlow, Craske, Cerny, & Klosko, 1989). In the present study, 30 patients with panic disorder received 12 sessions of CBT. Patients were evaluated at pre- and posttreatment with measures assessing the full spectrum of symptoms associated with panic disorder (panic attacks, agoraphobia, generalized anxiety, depression). Following treatment, there were significant and clinically meaningful reductions on all measures. In order to determine how well the efficacy of CBT generalizes to nonresearch clinical settings and to ethnically diverse urban populations, data in the present study were compared to those collected by Barlow and associates (1989). Patients in our clinical setting showed higher pretreatment levels of symptomatology than patients in Barlow and colleagues’ (1989) research setting, but similar posttreatment symptom levels and response rates. Thus, this study provides evidence for the generalizability of CBT from clinical research centers to clinically representative settings.

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Panic Disorder with Choking Phobia : a Case Report

Scientia Psychiatrica ◽

10.37275/scipsy.v1i2.11 ◽

2020 ◽

Vol 1 (2) ◽

pp. 25-30

Author(s):

Patricia Wulandari

Keyword(s):

Case Report ◽

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Panic Attack ◽

The Body ◽

Self Control ◽

Panic Attacks ◽

Cognitive Behavior ◽

Loss Of Self

Abstract Panic disorder is a form of anxiety disorder characterized by repeated panic attacks and preoccupied with worrying that a panic attack will occur. Panic attacks are characterized by fears of a disaster or loss of self-control even though there is really nothing to worry about. Other symptoms experienced during a panic attack are heart palpitations (similar to a heart attack), shortness of breath, feelings of suffocation, and the body feels weak. If this disorder is not detected early, it will affect the daily life of the patient. This case report presents the case of a 34-year-old woman who experiences symptoms of panic disorder with choking phobia that is managed with antidepressants and cognitive behavior therapy. In addition, there is discussion of differential diagnosis and the role of cognitive behavior therapy in handling this case.

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Cognitive behavior therapy to assist medication discontinuation in panic disorder

PsycEXTRA Dataset ◽

10.1037/e533122009-005 ◽

1999 ◽

Author(s):

Timothy J. Bruce

Keyword(s):

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cognitive Behavior ◽

Medication Discontinuation

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Faculty Opinions recommendation of Can pill placebo augment cognitive-behavior therapy for panic disorder?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1145067.602195 ◽

2009 ◽

Author(s):

Giampaolo Perna ◽

Massimiliano Grassi

Keyword(s):

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cognitive Behavior

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Faculty Opinions recommendation of Efficacy of d-cycloserine for enhancing response to cognitive-behavior therapy for panic disorder.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718356454.793494081 ◽

2014 ◽

Author(s):

Daniel Geller

Keyword(s):

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Cognitive Behavior

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Relationship of psychiatric comorbidity and treatment of panic disorder and agoraphobia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0608267l ◽

2006 ◽

Vol 134 (7-8) ◽

pp. 267-272

Author(s):

Milan Latas ◽

Vladan Starcevic ◽

Goran Trajkovic

Keyword(s):

Panic Disorder ◽

Psychiatric Disorders ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Psychiatric Comorbidity ◽

Integrative Model ◽

Treatment Modalities ◽

Cognitive Behavior ◽

Comorbid Psychiatric Disorders ◽

Relationship Of

Introduction. Besides numerous studies that examined various aspects of comorbidity in patients with panic disorder and agoraphobia and numerous studies that examined efficacy of different treatment modalities in these patients, there was no study that examined relationship of overall psychiatric comorbidity and treatment of patients with panic disorder and agoraphobia. Objective. The objective of the study was to establish the effect of psychiatric comorbidity on treatment efficiency of patients with panic disorder and agoraphobia. Method. The sample of the study consisted of 119 patients with primary diagnosis of panic disorder and agoraphobia. The therapy of patients was based on the use of individual integrative model of treatment, which incorporated psycho-pharmaceuticals (benzodiazepines and antidepressants) and cognitive- behavior therapy. Symptom severity was estimated by Panic and Agoraphobia Scale before and after the completion of treatment. Patients with comorbidity and patients without any comorbidity were compared by MANOVA and ANOVA with repeated measures. Results. The results of the study showed that 91% of patients met diagnostic criteria of comorbid psychiatric disorder and these patients had more severe clinical picture than patients without any comorbid disorder before the treatment. The results also showed that, after the completion of treatment, there was a significant reduction of all analyzed symptoms, that the effects of treatment were significantly better in patients with psychiatric comorbidity and that comorbid psychiatric disorders had no negative effect on the main goals of the treatment. Conclusion. Based on these results, it may be concluded that: in patients with panic disorder and agoraphobia and comorbid psychiatric disorders, the pharmacotherapy must be based on simultaneous use of antidepressants and benzodiazepines, while standard cognitive-behavior therapy of patients with panic disorder and agoraphobia must be modified in case of the existing comorbid psychiatric disorders.

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