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Specialist Therapy Most Effective for Panic Disorder

Behavioral therapy plus drugs beats counselling and medication, study finds

FRIDAY, March 11, 2005 (HealthDay News) -- Individuals with panic disorders may benefit more from professional cognitive behavioral therapy plus medication 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.

SOURCE: JAMA/Archives Journals, news release, March 7, 2005
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