A meta-analysis of treatment outcome for panic disorder

Gould, Robert A.; Ott, Michael W.; Pollack, Mark H.

doi:10.1016/0272-7358(95)00048-8

Cited by 473 publications

(351 citation statements)

References 53 publications

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“…Effect sizes (ES) between the treatment conditions and the wait-list calculated on the post-treatment composite scores (Gould et al, 1995.) The treatments were all more effective than the wait-list, with large effect sizes overall, …”

Section: Resultsmentioning

confidence: 99%

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A Comparison of Delivery Methods of Cognitive-Behavioral Therapy for Panic Disorder: An International Multicenter Trial.

Kenardy¹,

Dow

Johnston

et al. 2003

Journal of Consulting and Clinical Psychology

126

131

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Cognitive--behavioral therapy (CBT) is the psychological treatment of choice for panic disorder (PD). However, given limited access to CBT, it must be delivered with maximal cost-effectiveness. Previous researchers have found that a brief computer-augmented CBT was as effective as extended therapistdelivered CBT. To test this finding, this study randomly allocated 186 patients with PD across 2 sites in Scotland and Australia to 12 sessions of therapist-delivered CBT (CBT12), 6 sessions of therapistdelivered (CBT6) or computer-augmented CBT (CBT6-CA), or a waitlist control. On a composite measure, at posttreatment, the outcome for CBT12 was statistically better than the outcome for CBT6. The outcome for CBT6-CA fell between CBT12 and CBT6, but could not be statistically distinguished from either treatment. The active treatments did not differ statistically at 6-month follow-up. The study provided some support for the use of computers as an innovative adjunctive-therapy tool and merits further investigation.Substantial research evidence indicates that the psychological treatment of choice for panic disorder is cognitive-behavioral therapy (CBT) intervention (Barlow, Gorman, Shear, & Woods, 2000;Hofmann & Spiegel, 1999;Otto, Pollack, & Maki, 2000). As a result, there has been a corresponding growth of demand for treatment, an increase in waiting times in some health care systems, and consequently, pressure for more accessible and efficient forms of treatment delivery.This need is further highlighted by the high prevalence of panic disorder (Kessler et al., 1994) as well as by the nature of the condition, which often involves a level of agoraphobic avoidance. This may limit patients' regular clinic attendance and their access to conventional therapist-administered treatment (Co ˆte ´, Gauthier, Laberge, Cormier, & Plamondon, 1994). To date, one of the main alternatives to conventional CBT delivery has involved the use of written self-help materials, or bibliotherapy.Bibliotherapy (Dow, 1982) has proven to be as effective as eight sessions of group or individual CBT (Lidren et al., 1994), although Power, Sharp, Swanson, andSimpson (2000) found a totally self-administered bibliotherapy condition to be significantly less effective on a range of outcome measures compared with "standard" therapist-delivered CBT. This may be related to the inaccessibility and inconvenience of bibliotherapy during daily activities. One possible solution to the limits of bibliotherapy lies in computer-assisted therapy.Computers can increase patient access to treatment programs (Kenardy, McCafferty, & Rosa, 2003); extend therapy to the patient's own environment; and enhance cost-effectiveness, with costs reduced to between one third and one sixth that of conventional behavioral treatment (Kenardy & Adams, 1993;Newman, 2000). Computer programs have been shown to be effective adjuncts to more conventional treatment for a variety of anxiety disorders, including panic disorder, agoraphobia, social phobia, obsessive-compulsive disorder, and gener...

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Section: Resultsmentioning

confidence: 99%

“…A coding system was used in which one category was designated a reference category (Tabachnick & Fidell 1996). Sample size was based on a mean effect size for CBT for panic disorder of 0.68 (Gould, et al, 1995), and calculated based on 80% power, two-tailed α = 0.05, and a drop-out rate of 10-15%.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Delivery Methods of Cognitive-Behavioral Therapy for Panic Disorder: An International Multicenter Trial.

Kenardy¹,

Dow

Johnston

et al. 2003

Journal of Consulting and Clinical Psychology

126

131

View full text Add to dashboard Cite

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“…Six health economic studies of CBT for anxiety disorders were identified (10,11,14,33,43,45). A total of 232 primary care patients with PD were randomized to a combined CBT and pharmacology condition or to TAU (33).…”

Section: Abbreviations Used In This Articlementioning

confidence: 99%

“…A metaanalysis of PD outcomes compared direct costs of 15 CBT sessions with boosters to medication (10). At 1 year, the cheapest intervention was imipramine, closely followed by group CBT and individual CBT.…”

Section: Abbreviations Used In This Articlementioning

confidence: 99%

Cost-Effectiveness of Cognitive-Behavioural Therapy for Mental Disorders: Implications for Public Health Care Funding Policy in Canada

Myhr

Payne

2006

Can J Psychiatry

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T he total cost of mental illness in Canada has been estimated at $14.4 billion (1998 dollars), which includes both direct and indirect costs (1). Mental illness accounts for more than 50% of physician billing and uses more hospital bed-days than cancer (2). Medications are considered first-line, mainstay treatment for mental health disorders and contribute most to rising care costs (3). There is growing interest, therefore, in nonpharmacologic interventions with strong empirical support, such as CBT.

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“…9 Numerous studies have confirmed the effectiveness of drug therapy for PD. [10][11][12] Among the pharmacological options used in the treatment of PD are selective serotonin reuptake inhibitors (SSRI), tricyclic antidepressants (TAD), monoamine oxidase inhibitors (MAOI), serotonin and noradrenaline reuptake inhibitors (SNRI), and benzodiazepines. 13 However, many patients, although being under drug therapy, remain symptomatic and have recurrence of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Terapia cognitivo-comportamental no transtorno de pânico

Manfro

Heldt

Cordioli

et al. 2008

Rev. Bras. Psiquiatr.

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Introduction Panic disorder (PD) is characterized by the presence of sudden anxiety attacks, followed by physical and affective symptoms, fear of having a new attack and avoidance of events or situations in which panic attacks have occurred.1 The course of PD tends to be chronic in the majority of patients, 2,3 and PD is associated with a reduced quality of life and impaired psychosocial functioning.

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A meta-analysis of treatment outcome for panic disorder

Cited by 473 publications

References 53 publications

A Comparison of Delivery Methods of Cognitive-Behavioral Therapy for Panic Disorder: An International Multicenter Trial.

A Comparison of Delivery Methods of Cognitive-Behavioral Therapy for Panic Disorder: An International Multicenter Trial.

Cost-Effectiveness of Cognitive-Behavioural Therapy for Mental Disorders: Implications for Public Health Care Funding Policy in Canada

Terapia cognitivo-comportamental no transtorno de pânico

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