Individuals with panic disorders
may benefit more from professional cognitive behavioral therapy
than simply being given drugs and counseling by their primary
care doctor, researchers report.
The first combination "resulted
in sustained and gradually increasing improvement relative
to treatment as usual," concluded researchers at the University
of Washington School of Medicine at Harborview Medical Center
in Seattle.
They randomly assigned 232
people with panic disorder to receive either usual treatment
-- medication and counseling from a primary care doctor --
or treatment that included up to six sessions of specialist-delivered
cognitive behavioral therapy over three months, along with
up to six follow-up telephone contacts over the following
nine months.
The patients in the behavioral
therapy group also received medications provided by a primary
care doctor with the guidance of a psychiatrist.
Reporting in the March issue
of Archives of General Psychiatry, the researchers
found that, at three months, 20 percent of the behavioral
therapy/medication patients had minimal anxiety about panic,
a low score on a test measuring agoraphobia (fear of going
out) and had suffered no panic attacks within the previous
month, compared with 12 percent of the patients in the usual
care group.
After a year, those rates climbed
to 29 percent and 16 percent, respectively.
The authors note, however,
that many patients in the cognitive behavioral therapy group
did not adhere to the entire program, even though it was brief
and featured flexible scheduling.
"This finding suggests the
need for qualitative research to elucidate the reasons for
nonadherence in these patients," the authors wrote.
More information
The U.S. National Institute
of Mental Health has more about panic
disorder.