Reduced therapist contact in the cognitive behavioral treatment of panic disorder

Côté, Guillaume; Gauthier, Janel; Laberge, Benoît; Cormier, Hubert; Plamondon, Jacques

doi:10.1016/s0005-7894(05)80149-2

Cited by 55 publications

(14 citation statements)

References 43 publications

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“…Nine studies examined the impact of concurrent use of any psychotropic medication on symptom improvement in CBT, and all found that use of psychotropic medication did not predict improvement at post-treatment (Aaronson et al, 2008;Arch & Craske, 2007;Arntz, 2002;Côté, Gauthier, Laberge, Cormier, & Plamondon, 1994;Hecker, Losee, Fritzler, & Fink, 1996;Kenardy et al, 2003;McLean et al, 1998;Rufer, Albrecht, Zaum et al, 2010;Steketee et al, 2001; see Table 1), though Arch and Craske found that use of medication marginally predicted decreased improvement on one of two outcome measures. In three of these nine studies, patients were prohibited from changing their medication or dosage during treatment (Hecker et al, 1996;Kenardy et al, 2003;McLean et al, 1998;Steketee et al, 2001), indicating that these null findings cannot be attributed to a lack of predictive power due to changes in medication during treatment.…”

Section: Concurrent Use Of Medicationmentioning

confidence: 99%

A systematic review of predictors and moderators of improvement in cognitive-behavioral therapy for panic disorder and agoraphobia

Porter

Chambless

2015

Clinical Psychology Review

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Section: Concurrent Use Of Medicationmentioning

confidence: 99%

A systematic review of predictors and moderators of improvement in cognitive-behavioral therapy for panic disorder and agoraphobia

Porter

Chambless

2015

Clinical Psychology Review

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“…A smaller body of literature attests to the efficacy of briefer PCT protocols, typically administered in 4‐6 sessions and supplemented with periodic telephone contacts and/or computer‐aided administration . In routine medical practice, however, a full or abbreviated course of PCT is only feasible within headache specialty centers that employ qualified behavioral providers.…”

Section: Management and Treatmentmentioning

confidence: 99%

“…[151][152][153] A smaller body of literature attests to the efficacy of briefer PCT protocols, typically administered in 4-6 sessions and supplemented with periodic telephone contacts and/or computer-aided administration. [154][155][156][157] In routine medical practice, however, a full or abbreviated course of PCT is only feasible within headache specialty centers that employ qualified behavioral providers. In settings where these providers are not available, migraine patients with moderate to severe PD merit referral to a mental health professional for PCT, alone or in conjunction with pharmacotherapy.…”

Section: Management and Treatmentmentioning

confidence: 99%

Panic Disorder and Migraine: Comorbidity, Mechanisms, and Clinical Implications

2012

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A growing body of literature suggests that comorbid anxiety disorders are more common and more prognostically relevant among migraine sufferers than comorbid depression. Panic disorder (PD) appears to be more strongly associated with migraine than most other anxiety disorders. PD and migraine are both chronic diseases with episodic manifestations, involving significant functional impairment and shared symptoms during attacks, interictal anxiety concerning future attacks, and an absence of identifiable secondary pathology. A meta-analysis of high-quality epidemiologic study data from 1990 to 2012 indicates that the odds of PD are 3.76 times greater among individuals with migraine than those without. This association remains significant even after controlling for demographic variables and comorbid depression. Other less-rigorous community and clinical studies confirm these findings. The highest rates of PD are found among migraine with aura patients and those presenting to specialty clinics. Presence of PD is associated with greater negative impact of migraine, including more frequent attacks, increased disability, and risk for chronification and medication overuse. The mechanisms underlying this common comorbidity are poorly understood, but both pathophysiological (eg, serotonergic dysfunction, hormonal influences, dysregulation of the hypothalamic-pituitary-adrenal axis) and psychological (eg, interoceptive conditioning, fear of pain, anxiety sensitivity, avoidance behavior) factors are implicated. Means of assessing comorbid PD among treatment-seeking migraineurs are reviewed, including verbal screening for core PD symptoms, ruling out medical conditions with panic-like features, and administering validated self-report measures. Finally, evidence-based strategies for both pharmacologic and behavioral management are outlined. The first-line migraine prophylactics are not indicated for PD, and the selective serotonin re-uptake inhibitors used to treat PD are not efficacious for migraine; thus, separate agents are often required to address each condition. Core components of behavioral treatments for PD are reviewed, and their integration into clinical headache practice is discussed.

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“…PCT has been evaluated by Barlow, Craske, Cerny, and Klosko (1989), Klosko, Barlow, Tassinari, and Cerny (1990) and independently, e.g. by Telch et al (1993) and Coté, Gauthier, Laberge, Cormier, and Plamondon (1994). Overall, these studies show that at post-treatment assessment, about 80% of patients are panic-free, and at follow-up (on average one year) about 87% are panic-free.…”

mentioning

confidence: 99%

Brief Cognitive Behaviour Therapy of Panic Disorder

Westling¹,

Öst²

1999

Scandinavian Journal of Behaviour Therapy

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The aim of the present pilot study was to investigate if it is possible to treat patients having panic disorder with or without mild agoraphobia in a brief, four-session format without losing clinical efficacy. Ten patients fulfilling the DSM-III-R criteria for this disorder received cognitivebehaviour therapy based on the Clark (1989) treatment, but reduced from 12 to 4 sessions (1 hour a week for four weeks). The reduction was achieved by focusing only on the patients' core misinterpretation of bodily sensations and adding extensive homework compared to the original treatment. Patients were assessed pre-and post-treatment and at a 6-month follow-up with assessor ratings of anxiety and depression, self-observation of panic attacks and self-report measures of panic attacks, agoraphobia, general anxiety, agoraphobic cognitions, anxiety sensitivity and depression. The results show that the patients improved significantly on all measures and that this improvement was maintained at the follow-up. On four measures there was even further significant improvement from post-treatment to follow-up. Seventy percent of the patients were panic-free at post-treatment and 90% were panic-free at follow-up.

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Reduced therapist contact in the cognitive behavioral treatment of panic disorder

Cited by 55 publications

References 43 publications

A systematic review of predictors and moderators of improvement in cognitive-behavioral therapy for panic disorder and agoraphobia

A systematic review of predictors and moderators of improvement in cognitive-behavioral therapy for panic disorder and agoraphobia

Panic Disorder and Migraine: Comorbidity, Mechanisms, and Clinical Implications

Brief Cognitive Behaviour Therapy of Panic Disorder

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