The Impact of an 8-Day Intensive Treatment for Adolescent Panic Disorder and Agoraphobia on Comorbid Diagnoses

Abstract

Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for non-primary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for Panic Disorder with or without Agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; specifically Specific Phobias, Generalized Anxiety Disorder, and Social Phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets.

Parental Involvement in Intensive Treatment for Adolescent Panic Disorder and Its Impact on Depression

“…Based on a composite of the parent and adolescent report, this PDA diagnosis was assigned when the clinician-assigned clinical severity rating (CSR) was four or greater. As reported elsewhere, the majority of participants in this study examining the impact of intensive therapy on PDA met the criteria for at least one other comorbid disorder, but very few of them met the criteria for MDD (Gallo et al 2012). Participants also included mothers ( n = 53) and fathers ( n = 44) of the 57 adolescents.…”

“…Additionally, their therapists reported a decline in their panic severity as measured by a seven- point PD Severity Scale (Gallo et al 2014; Pincus et al in preparation). This intensive protocol was also found to reduce the number of comorbid clinical disorders, especially specific phobias, generalized anxiety disorder, and social phobia (Gallo et al 2012). Based on a clinical severity rating using diagnostic interviews, only four of these participants were clinically diagnosed with a mood disorder.…”

“…The authors of this study suggested that the full effects of CBT on depression may take longer than 6 weeks to emerge. Additionally, the study did not examine whether treatment reduced rates of subsyndromal depression and continuous depressive symptomatology across all the participants; rather, only the small handful of participants whose CSRs warranted a full diagnosis of MDD at baseline assessment were evaluated (Gallo et al 2012; Pincus et al in preparation). …”

Trajectories of Change Across Outcomes in Intensive Treatment for Adolescent Panic Disorder and Agoraphobia

“…Exclusionary criteria were diagnoses of schizophrenia, pervasive developmental disorders, organic brain syndromes, and mental retardation. Of the adolescents in the sample, 78.2% had at least one comorbid diagnosis at pretreatment (most commonly specific phobias, generalized anxiety disorder, and social phobia; Gallo, Chan, Buzzella, Whitton, & Pincus, 2012). In addition, adolescents with a plan for suicide were excluded and were referred for appropriate services.…”

Anxiety in Children

“…[42][43][44] We excluded one study published in Turkish [45][46][47] and three in Persian. 48 In addition, we identified 225 relevant ongoing trials through clinicaltrials.gov.…”