Cognitive behavior therapy vs exposure in vivo in the treatment of panic disorder with agoraphobia (corrected from agrophobia).
Seventy-three psychiatric outpatients with DSM-IV diagnosis of panic disorder with agoraphobia were assessed with a battery of independent assessor, self-observation, self-report and behavioral measures before and after therapy, and at a 1-yr follow-up. They were randomly assigned to Exposure in vivo (E; n = 25), Cognitive Behavior Therapy (CBT; n = 26), or a Wait-list control (WLC; n = 22) and received 12-16 individual therapy sessions, once weekly. The treatments yielded significant improvements, both on panic/agoraphobia measures and on measures of general anxiety, depression, social adjustment and quality of life, which were maintained at follow-up. However, there were no significant differences between E and CBT. The three criteria of clinically significant improvement were achieved by 67% of the E-patients and 79% of the CBT-patients at post-treatment, and 74% and 76%, respectively, at follow-up. The conclusion that can be drawn is that adding cognitive therapy to exposure did not yield significantly better results than for exposure alone.
Ost
Lars-Göran
LG
Department of Psychology, Stockholm University, S-106 91 Stockholm, Sweden. ost@psychology.su.se
Thulin
Ulrika
U
Ramnerö
Jonas
J
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000379:Agoraphobia / Q000523:psychology / Q000628:therapy*; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D012647:Self-Assessment; D016896:Treatment Outcome; D014850:Waiting Lists