Early intervention in panic: pragmatic randomised controlled trial.
BACKGROUND
Many people suffer from subthreshold and mild panic disorder and are at risk of developing more severe panic disorder.


OBJECTIVE
This study (trial registration: ISRCTN33407455) was conducted to evaluate the effectiveness of an early group intervention based on cognitive-behavioural principles to reduce panic disorder symptomatology.


METHODS
Participants with subthreshold or mild panic disorder were recruited from the general population and randomised to the intervention (n = 109) or a waiting-list control group (n = 108). The course was offered by 17 community mental health centres.


RESULTS
In the early intervention group, 43/109 (39%) participants presented with a clinically significant change on the Panic Disorder Severity Scale-Self Report (PDSS-SR) v. 17/108 (16%) in the control group (odds ratio (OR) for favourable treatment response 3.49, 95% CI 1.77-6.88, P = 0.001). The course also had a positive effect on DSM-IV panic disorder status (OR = 1.96, 95% CI=1.05-3.66, P = 0.037). The PDSS-SR symptom reduction was also substantial (between-group standardised mean difference of 0.68). The effects were maintained at 6-month follow-up.


CONCLUSIONS
People presenting with subthreshold and mild panic disorder benefit from this brief intervention.
Meulenbeek
Peter
P
GGNet, PO Box 2003, 7230 GC Warnsveld, The Netherlands. p.meulenbeek@compaqnet.nl
Willemse
Godelief
G
Smit
Filip
F
van Balkom
Anton
A
Spinhoven
Philip
P
Cuijpers
Pim
P
D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult