Does the Addition of Cognitive Behavioral Therapy Improve Panic Disorder Treatment Outcome Relative to Medication Alone in the Primary-Care Setting?

Psychol Med. 2005 Nov;35(11):1645-54. doi: 10.1017/S003329170500557X.

Abstract

Background: Randomized clinical trials indicate a benefit from combining medications with cognitive behavioral therapy (CBT) relative to medication alone for panic disorder. Using an as-treated analysis, we evaluated whether the addition of CBT enhanced outcomes for panic disorder relative to medications alone in the primary-care setting.

Method: Primary-care patients with panic disorder reported on their receipt of CBT and medications over the 3 months following baseline assessment. The degree to which outcomes for those who used anti-panic medications were enhanced by the receipt of at least one component of CBT was analyzed using a propensity score model that took into account observable baseline patient characteristics influencing both treatment selection and outcomes.

Results: The addition of CBT resulted in statistically and clinically significant improvements at 3 months on anxiety sensitivity, social avoidance, and disability. Also, patients receiving CBT in the first 3 months of the study were more improved at 12 months than patients who took medications only during the first 3 months of the study.

Conclusions: The clinical utility of the findings are discussed in terms of the importance of primary-care physicians encouraging their panic disorder patients to receive CBT as well as medications.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Anxiety Agents / therapeutic use*
  • Cognitive Behavioral Therapy*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Panic Disorder / psychology*
  • Panic Disorder / therapy*
  • Primary Health Care*
  • Treatment Outcome

Substances

  • Anti-Anxiety Agents