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A randomized clinical trial of cognitive behavioral therapy and interpersonal psychotherapy for panic disorder with agoraphobia

Published online by Cambridge University Press:  30 April 2012

S. P. F. Vos ,
M. J. H. Huibers ,
L. Diels  and
A. Arntz
S. P. F. Vos*
Affiliation:
Department of Clinical Psychological Science, Faculty of Neuroscience and Psychology, Maastricht University, The Netherlands
M. J. H. Huibers
Affiliation:
Department of Clinical Psychological Science, Faculty of Neuroscience and Psychology, Maastricht University, The Netherlands
L. Diels
Affiliation:
Regional Hospital AZ Vesalius, Tongeren, Belgium
A. Arntz
Affiliation:
Department of Clinical Psychological Science, Faculty of Neuroscience and Psychology, Maastricht University, The Netherlands
*
*Address for correspondence: S. P. F. Vos, M.Sc., Department of Clinical Psychological Science, Maastricht University, PO Box 616, NL-6200 MD Maastricht, The Netherlands. (Email: Sjoertje.vos@maastrichtuniversity.nl)
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Abstract

Background

Interpersonal psychotherapy (IPT) seems to be as effective as cognitive behavioral therapy (CBT) in the treatment of major depression. Because the onset of panic attacks is often related to increased interpersonal life stress, IPT has the potential to also treat panic disorder. To date, a preliminary open trial yielded promising results but there have been no randomized controlled trials directly comparing CBT and IPT for panic disorder.

Method

This study aimed to directly compare the effects of CBT versus IPT for the treatment of panic disorder with agoraphobia. Ninety-one adult patients with a primary diagnosis of DSM-III or DSM-IV panic disorder with agoraphobia were randomized. Primary outcomes were panic attack frequency and an idiosyncratic behavioral test. Secondary outcomes were panic and agoraphobia severity, panic-related cognitions, interpersonal functioning and general psychopathology. Measures were taken at 0, 3 and 4 months (baseline, end of treatment and follow-up).

Results

Intention-to-treat (ITT) analyses on the primary outcomes indicated superior effects for CBT in treating panic disorder with agoraphobia. Per-protocol analyses emphasized the differences between treatments and yielded larger effect sizes. Reductions in the secondary outcomes were equal for both treatments, except for agoraphobic complaints and behavior and the credibility ratings of negative interpretations of bodily sensations, all of which decreased more in CBT.

Conclusions

CBT is the preferred treatment for panic disorder with agoraphobia compared to IPT. Mechanisms of change should be investigated further, along with long-term outcomes.

Keywords

Agoraphobiacognitive behavioral therapyinterpersonal psychotherapypanic disorderrandomized clinical trial
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 12 , December 2012 , pp. 2661 - 2672
Copyright
Copyright © Cambridge University Press 2012

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