title: Long-term stability of cognitive behavioral therapy effects for panic disorder with agoraphobia: a two-year follow-up study.
abstract: OBJECTIVE
  Cognitive-behavioral therapy (CBT) aims to help patients establish new behaviors that will be maintained and adapted to the demands of new situations. The long-term outcomes are therefore crucial in testing the durability of CBT.
  
  
  METHODS
  A two-year follow-up assessment was undertaken on a subsample of n = 146 PD/AG patients from a multicenter randomized controlled trial. Treatment consisted of two variations of CBT: exposure in situ in the presence of the therapist (T+) or on their own following therapist preparation (T-).
  
  
  RESULTS
  Both variations of CBT had high response rates and, overall, maintained the level of symptomatology observed at post-treatment with high levels of clinical significance. Effect sizes 24 months following treatment were somewhat lower than at the 6-month follow up. Once patients reached responder status, they generally tended to remain responders at subsequent assessments. Differences were observed for patients that obtained additional treatment during the follow-up period. Expert opinion and subjective appraisal of treatment outcome differed. No robust baseline predictors of 2-year outcome were observed.
  
  
  CONCLUSIONS
  Most patients maintain clinically meaningful changes two years following treatment across multiple outcome measures. Approximately 1/3 of patients continued to experience meaningful residual problems.
authors.affiliation: Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Germany; University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Switzerland. Electronic address: andrew.gloster@unibas.ch.
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Gloster
authors.forename: Christina
authors.initials: C
authors.lastname: Hauke
authors.forename: Michael
authors.initials: M
authors.lastname: Höfler
authors.forename: Franziska
authors.initials: F
authors.lastname: Einsle
authors.forename: Thomas
authors.initials: T
authors.lastname: Fydrich
authors.forename: Alfons
authors.initials: A
authors.lastname: Hamm
authors.forename: Andreas
authors.initials: A
authors.lastname: Sthröhle
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000150:complications / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
keywords: Agoraphobia; CBT; Exposure; Long term follow-up; Non-responder; Panic