title: An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting.
abstract: Panic disorder with or without agoraphobia (PD/A) is common and can be treated effectively with selective serotonin reuptake inhibitor (SSRI) medication or cognitive-behaviour therapy (CBT). However, the lack of access to CBT services has motivated the development of self-help approaches requiring less therapist contact. A novel treatment modality in this field, showing efficacy in several randomized trials but until now not evaluated within the context of regular psychiatric care, is Internet-based treatment. The aim of the present study was to evaluate the effectiveness of Internet-based CBT for patients in a psychiatric setting. Twenty consecutively referred patients with PD were included in the study. A structured clinical interview with a psychiatrist was conducted for inclusion, as well as at post-treatment and at the 6-month follow-up. The treatment consisted of a 10-week CBT-based self-help programme, including minimal therapist support by e-mail. At post-treatment, 94% of patients no longer met DSM-IV criteria for PD (82% at 6-month follow-up). The within-group effect sizes (for the main outcome PDSS; Panic Disorder Severity Scale) were Cohen's d=2.5 (pre- to post-treatment) and 2.8 (pre-treatment to follow-up), respectively. The proportion of responders on the PDSS was 75% at post-treatment and 70% at 6-month follow-up. The results supports earlier efficacy data on Internet-based CBT for PD and indicates that it is effective also within a regular psychiatric setting. However, a larger randomized controlled trial should be conducted, directly comparing Internet-based CBT with traditionally administered CBT within such a setting.
authors.affiliation: Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institutet, Stockholm, Sweden. Jan.O.Bergstrom@ki.se
authors.forename: Jan
authors.initials: J
authors.lastname: Bergström
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.forename: Andreas
authors.initials: A
authors.lastname: Karlsson
authors.forename: Sergej
authors.initials: S
authors.lastname: Andréewitch
authors.forename: Christian
authors.initials: C
authors.lastname: Rück
authors.forename: Per
authors.initials: P
authors.lastname: Carlbring
authors.forename: Nils
authors.initials: N
authors.lastname: Lindefors
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006778:Hospitals, Psychiatric; D006801:Humans; D020407:Internet; D008297:Male; D010044:Outpatient Clinics, Hospital; D016584:Panic Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D010552:Personality Assessment / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012648:Self Care / Q000523:psychology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013548:Sweden; D013813:Therapy, Computer-Assisted
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors