Remote treatment of panic disorder: a randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls.
OBJECTIVE
This study evaluated a 10-week Internet-based bibliotherapy self-help program with short weekly telephone calls for people suffering from panic disorder with or without agoraphobia.


METHODS
After the authors confirmed the diagnosis by administering the Structured Clinical Interview for DSM-IV by telephone, 60 participants were randomly assigned to either a wait-listed control group or a multimodal treatment package based on cognitive behavior therapy plus minimal therapist contact via e-mail. A 10-minute telephone call was made each week to support each participant. Total mean time spent on each participant during the 10 weeks was 3.9 hours. The participants were required to send in homework assignments before receiving the next treatment module.


RESULTS
Analyses were conducted on an intention-to-treat basis, which included all randomly assigned participants. From pretreatment to posttreatment, all treated participants improved significantly on all measured dimensions (bodily interpretations, maladaptive cognitions, avoidance, general anxiety and depression levels, and quality of life). Treatment gains on self-report measures were maintained at the 9-month follow-up. A blind telephone interview after the end of treatment revealed that 77% of the treated patients no longer fulfilled the criteria for panic disorder, whereas all of the wait-listed subjects still suffered from it.


CONCLUSIONS
This study provides evidence to support the use of treatment distributed via the Internet with the addition of short weekly telephone calls to treat panic disorder. Replication should be made to compare self-help and telephone treatment based on cognitive behavior methods with nonspecific interventions.
Carlbring
Per
P
Department of Behavioural Sciences, Linkoping University, SE-581 83 Linkoping, Sweden. perca@ibv.liu.se
Bohman
Susanna
S
Brunt
Sara
S
Buhrman
Monica
M
Westling
Bengt E
BE
Ekselius
Lisa
L
Andersson
Gerhard
G
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D035061:Control Groups; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D020407:Internet; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010555:Personality Inventory / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life; D019114:Remote Consultation / Q000379:methods*; D012648:Self Care / Q000379:methods*; D012944:Social Support; D013689:Telephone; D016896:Treatment Outcome; D014850:Waiting Lists