Effects of cognitive behavioral treatment on physical health status in patients with panic disorder

Schmidt, Norman B.; McCreary, Beth T.; Trakowski, John J.; Santiago, Helen T.; Woolaway-Bickel, Kelly; Ialongo, Nicholas S.

doi:10.1016/s0005-7894(03)80021-7

Cited by 12 publications

(6 citation statements)

References 53 publications

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“…The 42 comparisons between CBT and control conditions in PAD resulted in a pooled effect size of g=0.81 (95% CI: 0.59‐1.04; I 2 =77; NNT=3.53). In the vast majority of the comparisons (N=33), a waiting list control condition was used.…”

Section: Resultsmentioning

confidence: 99%

How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta‐analytic update of the evidence

et al. 2016

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We report the current best estimate of the effects of cognitive behavior therapy (CBT) in the treatment of major depression (MDD), generalized anxiety disorder (GAD), panic disorder (PAD) and social anxiety disorder (SAD), taking into account publication bias, the quality of trials, and the influence of waiting list control groups on the outcomes. In our meta-analyses, we included randomized trials comparing CBT with a control condition (waiting list, care-as-usual or pill placebo) in the acute treatment of MDD, GAD, PAD or SAD, diagnosed on the basis of a structured interview. We found that the overall effects in the 144 included trials (184 comparisons) for all four disorders were large, ranging from g50.75 for MDD to g50.80 for GAD, g50.81 for PAD, and g50.88 for SAD. Publication bias mostly affected the outcomes of CBT in GAD (adjusted g50.59) and MDD (adjusted g50.65), but not those in PAD and SAD. Only 17.4% of the included trials were considered to be high-quality, and this mostly affected the outcomes for PAD (g50.61) and SAD (g50.76). More than 80% of trials in anxiety disorders used waiting list control groups, and the few studies using other control groups pointed at much smaller effect sizes for CBT. We conclude that CBT is probably effective in the treatment of MDD, GAD, PAD and SAD; that the effects are large when the control condition is waiting list, but small to moderate when it is care-as-usual or pill placebo; and that, because of the small number of high-quality trials, these effects are still uncertain and should be considered with caution.Key words: Cognitive behavior therapy, major depression, generalized anxiety disorder, panic disorder, social anxiety disorder, meta-analysis, publication bias, quality of trials, waiting list control groups (World Psychiatry 2016;15:245-258) Every year almost 20% of the general population suffers from a common mental disorder, such as depression or an anxiety disorder 1 . These conditions not only result in personal suffering for patients and their families, but also in huge economic costs, in terms of both work productivity loss and health and social care expenditures 2-6 .Several evidence-based treatments are available for common mental disorders, including pharmacological and psychological interventions. Many patients receive pharmacological treatments, and these numbers are increasing in high-income countries 7 . Psychological treatments are equally effective in the treatment of depression 8 and anxiety disorders [9][10][11] . However, they are less available or accessible 12 , especially in low-and middle-income countries. At the same time, about 75% of patients prefer psychotherapy over the use of medication 13 . The most extensively tested form of psychotherapy is cognitive behavior therapy (CBT). Dozens of trials and several meta-analyses have shown that CBT is effective in treating depression 8,14 and anxiety disorders 9-11 . However, in recent years, it has become clear that the effects of CBT and other psychotherapies have been considerably ...

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Section: Resultsmentioning

confidence: 99%

How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta‐analytic update of the evidence

et al. 2016

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“…No effects appeared for the other variables in the area of physical health. This is in agreement with previous research, which has shown that the effect of CBT on physical health is uncertain (Roy‐Byrne et al ., ; Schmidt et al ., ). The clients turned out to score on or slightly below the Swedish norm value for women 25–34 years of age (Sullivan et al ., ) in terms of physical health measurements PF, RP and BP, which indicates that the clients were already within the normal range at baseline.…”

Section: Discussionmentioning

confidence: 97%

“…() indicated that CBT is effective for the decrease of anxiety and depressive symptoms, but non‐effective in terms of physical health. Meanwhile, some studies suggest increased physical health and functioning after CBT (Niles, Sherbourne, Roy‐Byrne et al ., ; Schmidt, McCreary, Trakowski, Santiago, Woolaway‐Bickel & Ialongo, ).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of cognitive behavioral therapy on health‐related quality of life: An evaluation of therapies provided by trainee therapists

Henriksson

Anclair

Hiltunen

2016

Scandinavian J Psychology

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The present study was carried out to examine the treatment effect of cognitive behavioral therapy provided by trainee therapists at a university clinic, focusing on health-related quality of life (HRQOL) optimism and symptoms. The study was conducted through a repeated measures design and included a treatment group (n = 21), which received cognitive behavioral therapy for an average of 10.7 therapy sessions and a control group (n = 14), that was put on a wait list for 8.6 weeks on average. After treatment, the treatment group improved significantly concerning general health (p = 0.028) and optimism (p = 0.027). In addition, clients improved in several areas within mental health and displayed some reduction in anxiety symptoms. Concurrently, the results also indicated some improvement within the control group, which may have been caused by the initial therapeutic contact, expectancy effects or spontaneous remission. The study concluded that cognitive behavioral therapy provided by trainee therapists may have a positive effect on areas within HRQOL and optimism.

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“…However, because we included only randomized studies, medication should have been equally distributed between intervention and control groups and not influenced between-groups effect estimates. Indeed, several studies assessed the adequacy of their randomization process and reported no group differences in medication consumption (Lidren et al, 1994; Schmidt et al, 2000, 2003, 2012; Sharp et al, 2004; Telch et al, 1993). A fifth limitation is that studies were conducted in controlled research settings, and findings may not generalize to naturalistic treatment contexts.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of group psychotherapy for panic disorder: Meta-analysis of randomized, controlled trials.

Schwartze

Barkowski

Strauß

et al. 2017

Group Dynamics: Theory, Research, and Practice

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Among psychological treatments for panic disorder (PD) with or without agoraphobia, group therapy is an established and cost-effective treatment. The typical review assessing the effects of psychological treatments for PD merges findings from both individual and group formats. What is absent from the literature is a meta-analysis that separately summarizes the efficacy of group treatments. The present meta-analysis addresses this gap by estimating the efficacy of group psychotherapy for PD in adults using randomized, controlled trials (RCTs). More specifically, studies that directly compared the effects of group psychotherapy with control groups or alternative treatments were included. We identified 15 RCTs that yielded 19 comparisons with 864 patients. In most studies, group therapy was based on a cognitive–behavioral approach. Outcomes assessing panic, agoraphobia, depression, and general anxiety symptoms were extracted and between-groups effect sizes (Hedges’ g) calculated using a random-effects model. Results showed large effects for group therapy reducing symptoms of panic and agoraphobia when compared with no-treatment control groups (k = 9; g = 1.08; 95% confidence interval [CI] [0.82, 1.34]; p < .001). However, no significant differences were found when group therapy was compared with alternative treatments (k = 6; g = 0.18; 95% CI [−0.14, 0.49]; p = .264). This review adds support for group psychotherapy (primarily cognitive–behavioral therapy, CBT) being one of several treatment options for PD. Results are discussed with respect to the positive effects of group therapy and the limits of group therapy when compared with alternative treatments such as individual therapy or pharmacotherapy.

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Effects of cognitive behavioral treatment on physical health status in patients with panic disorder

Cited by 12 publications

References 53 publications

How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta‐analytic update of the evidence

How effective are cognitive behavior therapies for major depression and anxiety disorders? A meta‐analytic update of the evidence

Effectiveness of cognitive behavioral therapy on health‐related quality of life: An evaluation of therapies provided by trainee therapists

Efficacy of group psychotherapy for panic disorder: Meta-analysis of randomized, controlled trials.

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