Internet cognitive–behavioural treatment for panic disorder: randomised controlled trial and evidence of effectiveness in primary care

Abstract

BackgroundInternet cognitive–behavioural therapy (iCBT) for panic disorder of up to 10 lessons is well established. The utility of briefer programmes is unknown.AimsTo determine the efficacy and effectiveness of a five-lesson iCBT programme for panic disorder.MethodStudy 1 (efficacy): Randomised controlled trial comparing active iCBT (n=27) and waiting list control participants (n=36) on measures of panic severity and comorbid symptoms. Study 2 (effectiveness): 330 primary care patients completed the iCBT programme under the supervision of primary care practitioners.ResultsiCBT was significantly more effective than waiting list control in reducing panic (g=0.97, 95% CI 0.34 to 1.61), distress (g=0.92, 95% CI 0.28 to 1.55), disability (g=0.81, 95% CI 0.19 to 1.44) and depression (g=0.79, 95% CI 0.17 to 1.41), and gains were maintained at 3 months post-treatment (iCBT group). iCBT remained effective in primary care, but lower completion rates were found (56.1% in study 2 v. 63% in study 1). Adherence appeared to be related to therapist contact.ConclusionsThe five-lesson Panic Program has utility for treating panic disorder, which translates to primary care. Adherence may be enhanced with therapist contact.Declaration of interestNone.Copyright and usage© The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

The Use of Technology to Augment Clinical Care in Depression and Anxiety Disorders: An Evidence Map

“…After dual review of titles and abstracts to determine if the citation could meet eligibility criteria, 1,365 RCTs were selected for full-text dual review. Of these, 280 RCTs met the inclusion criteria and are included in the evidence map: Adler et al, 2015;Alavi et al, 2016;Alegria et al, 2014;Allen et al, 2016;Andersson et al, 2005;Andersson, Carlbring, and Furmark, 2012;Andersson et al, 2006;Andersson, Hesser, et al, 2013;Andersson et al, 2009;Andersson, Waara, et al, 2013;Andrews, Davies, and Titov, 2011;Arean et al, 2016;Au, 2015;Bae and Panuncio, 2008;Baikie, Geerligs, and Wilhelm, 2012;Beard and Amir, 2008;Bee et al, 2010;Beevers et al, 2017;Berger, Boettcher, and Caspar, 2014;Berger, Hämmerli, et al, 2011;Berger, Hohl, and Caspar, 2009;Berger et al, 2016;Bergström et al, 2010;Birney et al, 2016;Blackwell et al, 2015;Boeschoten et al, 2016;Boettcher, Aström, et al, 2014;Boettcher, Berger, and Renneberg, 2012;Boettcher, Hasselrot, et al, 2014;Boettcher et al, 2013;Bombardier et al, 2013;Bornas, Tortella-Feliu, and Llabrés, 2006;Botella et al, 2010;Botella et al, 2016;Bouchard et al, 2004;Brabyn et al, 2016;…”

Effects of Internet-Based Cognitive Behavioral Therapy in Routine Care for Adults in Treatment for Depression and Anxiety: Systematic Review and Meta-Analysis

“…To our knowledge, no recent meta-analysis has reported on pre-post effect sizes of studies targeting guided iCBT interventions for the treatment of anxiety. On an individual study level, pre-post effects in randomized trials ranged from 0.54 to 2.40 (please see Multimedia Appendix 8 for references) [ 133 - 162 ] compared with 0.66 to 1.88 in depression and 0.42 to 1.38 ( Hedges’ g ) in anxiety within this analysis.…”

Internet-Based Cognitive Behavioral Therapy for Symptoms of Depression and Anxiety Among Patients With a Recent Myocardial Infarction: The U-CARE Heart Randomized Controlled Trial

“…In this study, we recruited patients within a routine care setting using screening methods. However, treatment adherence to iCBT interventions has been found to be lower in effectiveness studies in primary care samples compared with samples recruited from Web-based self-referral [ 35 , 36 ]. It is likely that patients actively seeking out and self-referring to iCBT are more prone to stay active in treatment compared with those who are screened and offered participation.…”