Incremental Cost-effectiveness of Pharmacotherapy and Two Brief Cognitive-Behavioral Therapies Compared With Usual Care for Panic Disorder and Noncardiac Chest Pain

Poirier-Bisson, Joannie; Marchand, André; Pelland, Marie-Ève; Lessard, Marie-Josée; Dupuis, Gilles; Fleet, Richard; Roberge, Pasquale

doi:10.1097/nmd.0b013e3182a2127d

Cited by 11 publications

(7 citation statements)

References 40 publications

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“…This item was adapted from Eslick and Talley (8) and from Jonsbu, Dammen, Morken, and Martinsen (44). At follow-up, a medical interview was used to document medical diagnoses received after the emergency department visit, and the abbreviated version of the Health Cost Interview (45)(46)(47)(48) was used to assess medical visits between the two time points. PD and GAD diagnoses were assessed with the ADIS-IV (42).…”

Section: Methodsmentioning

confidence: 99%

Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity

Hamel

Denis

Turcotte

et al. 2021

Preprint

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BackgroundPatients with noncardiac chest pain (NCCP) report more severe symptoms and lowered health-related quality of life when they present with comorbid panic disorder (PD). Although generalized anxiety disorder (GAD) is the second most common psychiatric disorder in these patients, its impact on NCCP and health-related quality of life remains understudied. This study describes and prospectively compares patients with NCCP with or without PD or GAD in terms of (1) NCCP severity; and (2) the physical and mental components of health-related quality of life. MethodsA total of 915 patients with NCCP were consecutively recruited in two emergency departments. The presence of comorbid PD or GAD was assessed at baseline with the Anxiety Disorder Schedule for DSM-IV. NCCP severity at baseline and at the six-month followup was assessed with a structured telephone interview, and the patients completed the 12-item Short-Form Health Survey Version 2 (SF-12v2) to assess health-related quality of life at both time points. ResultsAverage NCCP severity decreased between baseline and the six-month follow-up ( p <.001) and was higher in the patients with comorbid PD or GAD ( p <.001) at both time points compared to those with NCCP only. However, average NCCP severity did not differ between patients with PD and those with GAD ( p = 0.901). The physical component of quality of life improved over time ( p = 0.016) and was significantly lower in the subset of patients with PD with or without comorbid GAD compared to the other groups ( p <.001). A significant time x group interaction was found for the mental component of quality of life ( p = 0.0499). GAD with or without comorbid PD was associated with a lower mental quality of life, and this effect increased at the six-month follow-up. ConclusionsComorbid PD or GAD are prospectively associated with increased chest pain severity and lowered health-related quality of life in patients with NCCP. PD appears to be mainly associated with the physical component of quality of life, while GAD has a greater association with the mental component. Knowledge of these differences could help in the management of patients with NCCP and these comorbidities.

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Section: Methodsmentioning

confidence: 99%

Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity

Hamel

Denis

Turcotte

et al. 2021

Preprint

Self Cite

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“…, Poirier‐Bisson et al . ). However, CBT is not common as a treatment for patients with panic disorder in South Korea.…”

Section: Introductionmentioning

confidence: 97%

“…, Poirier‐Bisson et al . ) in comparison to drug treatments. It also helps to promote medication discontinuation and prevent recurrence (Craske et al .…”

Section: Introductionmentioning

confidence: 99%

The effect of Korean‐group cognitive behavioural therapy among patients with panic disorder in clinic settings

Choi

Lee

Cho

2016

Psychiatric Ment Health Nurs

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Introduction In panic disorder, sensitivity to bodily sensations increases due to the patient's cognitive vulnerability. Cognitive behavioural therapy (CBT) can help to decrease sensitivity to bodily sensations by correcting these cognitive distortions by controlling negative thoughts and panic attacks. Aims This study verified whether group CBT is more effective than treatment as usual (TAU) in South Korean patients with panic disorder. Methods The study participants consisted of 76 panic disorder patients. Patients in the therapy condition attended sessions once a week for a total of 12 sessions in addition to drug treatment. Results In the therapy condition, there were significant decreases in panic-related bodily sensations and ranking and belief scores for catastrophic misinterpretation of external events. Discussion Group CBT, in comparison to TAU, decreases panic and agoraphobia symptom severity in South Korean patients with panic disorder. Our study provides evidence for the effectiveness of a panic disorder management programme that integrates group CBT and traditional pharmacotherapeutic treatment for patients with panic disorder. Implications for Practice The cognitive behavioural approach is needed to reduce panic and agoraphobia symptoms for hospitalized patients with panic disorder more than activity therapies, medications and supportive counselling by doctors and nurses.

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“…The computerized relaxation training programs may be more relevant to the rapidly growing group of individuals with psychological distress who does not meet the diagnostic criteria of psychiatric disorders (Hidaka, 2012;Craske and Stein, 2016) as this group may prefer to use easily accessible programs rather than seeking psychological therapy or interventions. Despite its increasing usage and reported therapeutic efficacy in mild psychological distress (Poirier-Bisson et al, 2013;Kisely et al, 2015), the underlying neurobiological mechanisms of relaxation training need further investigations.…”

Section: Introductionmentioning

confidence: 99%

Changes in Prefrontal Gamma-Aminobutyric Acid and Perfusion After the Computerized Relaxation Training in Women With Psychological Distress: A Preliminary Report

et al. 2021

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Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid (GABA) levels and cerebral blood flow (CBF) in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress (t = 4.02, P < 0.001), anxiety (z = 2.33, P = 0.02), fatigue (t = 3.35, P = 0.004), and sleep quality (t = 4.14, P < 0.001) improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms (t = −5.25, P < 0.001). The prefrontal GABA levels decreased (t = 2.53, P = 0.02), while relative CBF increased (t = −3.32, P = 0.004) after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention (t = 2.22, P = 0.04). The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress.

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Incremental Cost-effectiveness of Pharmacotherapy and Two Brief Cognitive-Behavioral Therapies Compared With Usual Care for Panic Disorder and Noncardiac Chest Pain

Cited by 11 publications

References 40 publications

Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity

Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity

The effect of Korean‐group cognitive behavioural therapy among patients with panic disorder in clinic settings

Changes in Prefrontal Gamma-Aminobutyric Acid and Perfusion After the Computerized Relaxation Training in Women With Psychological Distress: A Preliminary Report

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