A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders.
OBJECTIVE
To review current evidence for the clinical and cost-effectiveness of self-management interventions for panic disorder, phobias and obsessive-compulsive disorder (OCD).


METHODS
Papers were identified through computerized searches of databases for the years between 1995 and 2003, manual searches and personal contacts. Only randomized-controlled trials were reviewed.


RESULTS
Ten studies were identified (one OCD, five panic disorder, four phobias). Effective self-management interventions included cognitive-behavioural therapy (CBT) and exposure to the trigger stimuli for phobias and panic disorders. All involved homework. There was evidence of effectiveness in terms of improved symptoms and psychological wellbeing when compared with standard care, waiting list or relaxation. Brief interventions and computer-based interventions were effective for most participants. In terms of quality, studies were mainly based on small samples, lacked long-term follow-up, and failed to address cost-effectiveness.


CONCLUSIONS
Despite the limitations of reviewed studies, there appears to be sufficient evidence to warrant greater exploration of self-management in these disorders.
Barlow
J H
JH
Interdisciplinary Research Centre in Health, School of Health and Social Sciences, Coventry University, Coventry, UK. j.barlow@coventry.ac.uk
Ellard
D R
DR
Hainsworth
J M
JM
Jones
F R
FR
Fisher
A
A
D015928:Cognitive Behavioral Therapy / Q000191:economics; D003362:Cost-Benefit Analysis / Q000191:economics; D003887:Desensitization, Psychologic / Q000191:economics; D005500:Follow-Up Studies; D006801:Humans; D016584:Panic Disorder / Q000191:economics / Q000523:psychology / Q000628:therapy*; D010698:Phobic Disorders / Q000191:economics / Q000523:psychology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000191:economics / Q000379:methods / Q000523:psychology*; D016896:Treatment Outcome