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Early intervention in panic: pragmatic randomised controlled trial

  • Peter Meulenbeek (a1), Godelief Willemse (a2), Filip Smit (a3), Anton van Balkom (a4), Philip Spinhoven (a5) and Pim Cuijpers (a6)...



Many people suffer from subthreshold and mild panic disorder and are at risk of developing more severe panic disorder.


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.


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.


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.


People presenting with subthreshold and mild panic disorder benefit from this brief intervention.


Corresponding author

Correspondence: Peter Meulenbeek, GGNet, PO Box 2003, 7230 GC Warnsveld, The Netherlands. Email:


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Supported by The Netherlands Health Research Council, The Hague (ZonMw) grant number 50-50110-98-035 (awarded to F.S.).

Declaration of interest




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Early intervention in panic: pragmatic randomised controlled trial

  • Peter Meulenbeek (a1), Godelief Willemse (a2), Filip Smit (a3), Anton van Balkom (a4), Philip Spinhoven (a5) and Pim Cuijpers (a6)...
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