Cognitive behavioral therapy and medication is effective in the treatment of pani...( obia [fear of going out] was significa...),Health

obia [fear of going out], was significantly higher than those receiving usual care at all points--at three months, 20 percent versus 12 percent and at 12 months, 29 percent versus 16 percent. The proportion of patients who responded, defined by a low score on a test for anxiety level, was also significantly higher than those receiving usual care at all points--at three months, 46 percent versus 27 percent, and at 12 months, 63 percent versus 38 percent.

The patients receiving the CBT and medication intervention also made significantly greater improvements on two standard measures of mental health functioning. "These effects were obtained in spite of similar rates of delivery of guideline-concordant [appropriate, taken as directed] pharmacotherapy to the two groups," the authors write.

"We also learned that many patients did not adhere to the entire CBT program, even though it was brief and delivered with considerable flexibility of scheduling," the authors conclude. "This finding suggests the need for qualitative research to elucidate the reasons for nonadherence in these patients. A major goal of future work in this area should be to develop, implement, and disseminate approaches to treatment of anxiety disorders that are maximally acceptable to patients, physicians, and payers."

(Arch Gen Psychiatry. 2005; 62:290-298. Available post-embargo at www.archgenpsychiatry.com.)

Editor's Note: This study was funded by grants from the National Institutes of Health, Bethesda, Md.

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Contact: Susan Gregg-Hanson
206-731-4097
JAMA and Archives Journals
7-Mar-2005

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