A randomized controlled clinical trial of psychoanalytic psychotherapy for panic disorder.
OBJECTIVE
The purpose of this study was to determine the efficacy of panic-focused psychodynamic psychotherapy relative to applied relaxation training, a credible psychotherapy comparison condition. Despite the widespread clinical use of psychodynamic psychotherapies, randomized controlled clinical trials evaluating such psychotherapies for axis I disorders have lagged. To the authors' knowledge, this is the first efficacy randomized controlled clinical trial of panic-focused psychodynamic psychotherapy, a manualized psychoanalytical psychotherapy for patients with DSM-IV panic disorder.


METHODS
This was a randomized controlled clinical trial of subjects with primary DSM-IV panic disorder. Participants were recruited over 5 years in the New York City metropolitan area. Subjects were 49 adults ages 18-55 with primary DSM-IV panic disorder. All subjects received assigned treatment, panic-focused psychodynamic psychotherapy or applied relaxation training in twice-weekly sessions for 12 weeks. The Panic Disorder Severity Scale, rated by blinded independent evaluators, was the primary outcome measure.


RESULTS
Subjects in panic-focused psychodynamic psychotherapy had significantly greater reduction in severity of panic symptoms. Furthermore, those receiving panic-focused psychodynamic psychotherapy were significantly more likely to respond at treatment termination (73% versus 39%), using the Multicenter Panic Disorder Study response criteria. The secondary outcome, change in psychosocial functioning, mirrored these results.


CONCLUSIONS
Despite the small cohort size of this trial, it has demonstrated preliminary efficacy of panic-focused psychodynamic psychotherapy for panic disorder.
Milrod
Barbara
B
Weill Medical College of Cornell University, 525 East 68th St., New York, NY 10021, USA. bmilrod@med.cornell.edu
Leon
Andrew C
AC
Busch
Fredric
F
Rudden
Marie
M
Schwalberg
Michael
M
Clarkin
John
J
Aronson
Andrew
A
Singer
Meriamne
M
Turchin
Wendy
W
Klass
E Toby
ET
Graf
Elizabeth
E
Teres
Jed J
JJ
Shear
M Katherine
MK
D000328:Adult; D000379:Agoraphobia / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015331:Cohort Studies; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009519:New York City / Q000453:epidemiology; D016584:Panic Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011575:Psychoanalytic Therapy / Q000379:methods; D012064:Relaxation Therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome