A Randomized Controlled Clinical Trial of Psychoanalytic Psychotherapy for Panic Disorder

Milrod, Barbara; Leon, Andrew C.; Busch, Fred; Rudden, Marie G.; Schwalberg, Michael D.; Clarkin, John; Aronson, Andrew; Singer, Meriamne B.; Turchin, Wendy; Klass, Emily; Graf, B.A. Elizabeth; Teres, B.A. Jed J.; Shear, M. Katherine

doi:10.1176/ajp.2007.164.2.265

Cited by 226 publications

(78 citation statements)

References 23 publications

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“…It is of note that Berk and Parker [120] only referred to high-frequency long-term psychoanalytic therapy but did not include a discussion of manual-guided PDT. Several RCTs that fulfilled the criteria of Chambless and Hollon [8 ](table 1) included data on adverse events or side effects [40,43,47,49,50,52,55,64,74,77,95,122]. In these studies, adverse events or side effects were not more frequent in PDT than in the comparison treatments.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the treatment of depression, Thase [[65], p. 954] concluded from the RCT by Driessen et al [50] that there is no evidence that PDT is a less effective treatment of MDD than CBT [95]. On the other hand, Milrod et al [43] found PDT to be superior to applied relaxation in panic disorder. Clarkin et al [44] reported PDT and dialectical behavior therapy to be equally effective.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the 9 studies listed by Connolly Gibbons et al [7] for specific mental disorders [40,41,42,43,44,45,46,47,48], 30 more recent RCTs of PDT fulfilling the criteria by Chambless and Hollon [8] were identified. We did not include RCTs of irritable bowel syndrome or functional dyspepsia as they represent functional somatic disorders.…”

Section: Methodsmentioning

confidence: 99%

“…In the study by Milrod et al [43] PDT was more successful than applied relaxation in panic disorder. In another study, combining pharmacotherapy with PDT was shown to produce significantly lower relapse rates than pharmacotherapy alone [47].…”

Section: Methodsmentioning

confidence: 99%

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The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Leichsenring

Leweke

Klein

et al. 2015

Psychother Psychosom

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Background: The Task Force on Promotion and Dissemination of Psychological Procedures proposed rigorous criteria to define empirically supported psychotherapies. According to these criteria, 2 randomized controlled trials (RCTs) showing efficacy are required for a treatment to be designated as ‘efficacious' and 1 RCT for a designation as ‘possibly efficacious'. Applying these criteria modified by Chambless and Hollon, this article presents an update on the evidence for psychodynamic therapy (PDT) in specific mental disorders. Methods: A systematic search was performed using the criteria by Chambless and Hollon for study selection, as follows: (1) RCT of PDT in adults, (2) use of reliable and valid measures for diagnosis and outcome, (3) use of treatment manuals or manual-like guidelines, (4) adult population treated for specific problems and (5) PDT superior to no treatment, placebo or alternative treatment or equivalent to an established treatment. Results: A total of 39 RCTs were included. Following Chambless and Hollon, PDT can presently be designated as efficacious in major depressive disorder (MDD), social anxiety disorder, borderline and heterogeneous personality disorders, somatoform pain disorder, and anorexia nervosa. For MDD, this also applies to the combination with pharmacotherapy. PDT can be considered as possibly efficacious in dysthymia, complicated grief, panic disorder, generalized anxiety disorder, and substance abuse/dependence. Evidence is lacking for obsessive-compulsive, posttraumatic stress, bipolar and schizophrenia spectrum disorder(s). Conclusions: Evidence has emerged that PDT is efficacious or possibly efficacious in a wide range of common mental disorders. Further research is required for those disorders for which sufficient evidence does not yet exist.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

Leichsenring

Leweke

Klein

et al. 2015

Psychother Psychosom

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“…The emergence of new treatments for panic attacks has been negligible in recent years (Stirman, Toder, & Crits-Cristoph, 2010). As studies of multiple methods of the treatment of panic attacks all report a significant number of subjects, 29% -48%, who do not experience a lessening of symptoms, the need for an approach such as the one described in this article is clear (Milrod et al, 2007).…”

Section: Introductionmentioning

confidence: 93%

A One-Session Treatment Protocol for Panic Attacks

Robbins¹,

Parker²

2015

PSYCH

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This article describes in detail a one-session treatment protocol for panic attacks as well as the results of two small studies of its efficacy. The treatment protocol, typically completed in 75 -120 minutes, uses an innovative approach that combines the identification of bodily sensations and specific thoughts as the precursor or "starter" of the panic attack process. The exact treatment approach is described in detail. The results of two small studies using the protocol are analyzed. The results showed that a single session using the treatment approach produced a statistically significant, immediate decline in the reported number of panic attacks that were sustained over time. These results were achieved in two separate sets of subjects utilizing different facilitators. Descriptive information regarding the sample is also provided.

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Anxiety Disorders

Szuhany

Simon

2022

JAMA

172

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ImportanceAnxiety disorders have a lifetime prevalence of approximately 34% in the US, are often chronic, and significantly impair quality of life and functioning.ObservationsAnxiety disorders are characterized by symptoms that include worry, social and performance fears, unexpected and/or triggered panic attacks, anticipatory anxiety, and avoidance behaviors. Generalized anxiety disorder (6.2% lifetime prevalence), social anxiety disorder (13% lifetime prevalence), and panic disorder (5.2% lifetime prevalence) with or without agoraphobia are common anxiety disorders seen in primary care. Anxiety disorders are associated with physical symptoms, such as palpitations, shortness of breath, and dizziness. Brief screening measures applied in primary care, such as the Generalized Anxiety Disorder–7, can aid in diagnosis of anxiety disorders (sensitivity, 57.6% to 93.9%; specificity, 61% to 97%). Providing information about symptoms, diagnosis, and evidence-based treatments is a first step in helping patients with anxiety. First-line treatments include pharmacotherapy and psychotherapy. Selective serotonin reuptake inhibitors (SSRIs, eg, sertraline) and serotonin-norepinephrine reuptake inhibitors (SNRIs, eg, venlafaxine extended release) remain first-line pharmacotherapy for generalized anxiety disorder, social anxiety disorder, and panic disorder. Meta-analyses suggest that SSRIs and SNRIs are associated with small to medium effect sizes compared with placebo (eg, generalized anxiety disorder: standardized mean difference [SMD], −0.55 [95% CI, −0.64 to −0.46]; social anxiety disorder: SMD, −0.67 [95% CI, −0.76 to −0.58]; panic disorder: SMD, −0.30 [95% CI, −0.37 to −0.23]). Cognitive behavioral therapy is the psychotherapy with the most evidence of efficacy for anxiety disorders compared with psychological or pill placebo (eg, generalized anxiety disorder: Hedges g = 1.01 [large effect size] [95% CI, 0.44 to 1.57]; social anxiety disorder: Hedges g = 0.41 [small to medium effect] [95% CI, 0.25 to 0.57]; panic disorder: Hedges g = 0.39 [small to medium effect[ [95% CI, 0.12 to 0.65]), including in primary care. When selecting treatment, clinicians should consider patient preference, current and prior treatments, medical and psychiatric comorbid illnesses, age, sex, and reproductive planning, as well as cost and access to care.Conclusions and RelevanceAnxiety disorders affect approximately 34% of adults during their lifetime in the US and are associated with significant distress and impairment. First-line treatments for anxiety disorders include cognitive behavioral therapy, SSRIs such as sertraline, and SNRIs such as venlafaxine extended release.

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A Randomized Controlled Clinical Trial of Psychoanalytic Psychotherapy for Panic Disorder

Abstract: Despite the small cohort size of this trial, it has demonstrated preliminary efficacy of panic-focused psychodynamic psychotherapy for panic disorder.

Cited by 226 publications

References 23 publications

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

The Empirical Status of Psychodynamic Psychotherapy - An Update: Bambi's Alive and Kicking

A One-Session Treatment Protocol for Panic Attacks

Anxiety Disorders

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