Cognitive behavior therapy in panic disorder and comorbid major depression. A naturalistic study.
BACKGROUND
There is a lack of evidence about the effectiveness of cognitive behavior therapies (CBT) in settings of routine clinical care as well as in the treatment of panic and comorbid disorders.


METHODS
We investigated a group-oriented CBT approach for 80 patients with panic disorder including 35 patients with current comorbid major depression. Assessments took place 6 months before treatment, at the beginning and end of treatment, and 1 year later. Structured interviews and multiple clinical self-rating scales were used.


RESULTS
Panic patients with comorbid major depression showed higher anxiety-specific and nonspecific pathology. The most striking benefits were in reducing avoidance behavior, while improvements concerning catastrophic beliefs were smaller, but still significant. For most self-rating scale results, patients with and without comorbid depression improved to a comparable degree. However, the end-state functioning of patients with panic disorder and current comorbid depression at admission is significantly lower than for patients with panic disorder alone.


CONCLUSIONS
The results point to the necessity to develop and improve treatment approaches for patients with comorbidity of panic disorder and current major depression.
Rief
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W
Center for Behavioral Medicine Roseneck, Prien a. Ch., University of Munich, Germany. WRIEF@Schoen-Kliniken.de
Trenkamp
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Auer
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Fichter
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D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000150:complications* / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome