Panic disorder is one of the most disabling and costly anxiety disorders and is commonly treated in primary care settings, according to background information in the article. This randomized, controlled trial assesses the extent to which the benefits of evidence-based, specialist-delivered, panic disorder interventions can be generalized to primary care settings with non-specialist therapists and more diverse patient populations.
Peter P. Roy-Bryne, M.D., of the University of Washington School of Medicine at Harborview Medical Center, Seattle, and colleagues randomly assigned 232 primary-care patients meeting the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) criteria for panic disorder to receive treatment as usual (medication and counseling from the physician on recognition and treatment of panic disorder) or to receive an intervention consisting of up to six sessions in the course of three months of CBT, with up to six follow-up telephone contacts during the next nine months, and medications provided by the primary care physician with guidance from a psychiatrist. The patients were selected from six primary care clinics associated with three university medical schools, serving a diverse patient population.
"The combined cognitive-behavioral and pharmacotherapeutic [medications] intervention resulted in sustained and gradually increasing improvement relative to treatment as usual," the authors state. The proportion of patients who remitted, defined as patients who had had no panic attacks in the past month, minimal anticipatory anxiety about panic and a low score on a measure of agoraph
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