The Differential Impact of Expectancies and Symptom Severity on Cognitive Behavior Therapy Outcome in Panic Disorder with Agoraphobia

Abstract Study objectives To evaluate the effects of digital cognitive behavior therapy for insomnia (dCBT-I) delivered during pregnancy on subjective sleep outcomes, depressive symptoms, and anxiety symptoms through six months postpartum. Methods People up to 28 weeks gestation (N=208) with insomnia were randomized to six weekly sessions of dCBT-I or standard care. We report follow-up data at three and six months postpartum. The primary outcome was insomnia symptom severity. Secondary sleep outcomes included global sleep quality and insomnia caseness. Mental health outcomes included depressive and anxiety symptom severity. We evaluated between-condition differences in change from baseline for each postpartum timepoint and categorical outcomes. Results dCBT-I participants did not experience significantly greater improvements in insomnia symptom severity relative to standard care participants, but they did experience higher rates of insomnia remission and lower rates of insomnia caseness at six months postpartum. dCBT-I participants experienced greater improvements in depressive symptom severity from baseline to both postpartum timepoints, and in anxiety symptom severity from baseline to three months postpartum. The proportion of participants with probable major depression at three months postpartum was significantly higher among standard care (18%) than dCBT-I (4%, p=.006) participants; this between-condition difference was pronounced among the subset (n=143) with minimal depressive symptoms at baseline (18% vs 0%). Conclusion dCBT-I use during pregnancy leads to enduring benefits for postpartum insomnia remission. Findings provide strong preliminary evidence that dCBT-I use during pregnancy may prevent postpartum depression and anxiety, which is notable when considering the high frequency and importance of these problems.

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Relationship of psychiatric comorbidity and treatment of panic disorder and agoraphobia

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0608267l ◽

2006 ◽

Vol 134 (7-8) ◽

pp. 267-272

Author(s):

Milan Latas ◽

Vladan Starcevic ◽

Goran Trajkovic

Keyword(s):

Panic Disorder ◽

Psychiatric Disorders ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Psychiatric Comorbidity ◽

Integrative Model ◽

Treatment Modalities ◽

Cognitive Behavior ◽

Comorbid Psychiatric Disorders ◽

Relationship Of

Introduction. Besides numerous studies that examined various aspects of comorbidity in patients with panic disorder and agoraphobia and numerous studies that examined efficacy of different treatment modalities in these patients, there was no study that examined relationship of overall psychiatric comorbidity and treatment of patients with panic disorder and agoraphobia. Objective. The objective of the study was to establish the effect of psychiatric comorbidity on treatment efficiency of patients with panic disorder and agoraphobia. Method. The sample of the study consisted of 119 patients with primary diagnosis of panic disorder and agoraphobia. The therapy of patients was based on the use of individual integrative model of treatment, which incorporated psycho-pharmaceuticals (benzodiazepines and antidepressants) and cognitive- behavior therapy. Symptom severity was estimated by Panic and Agoraphobia Scale before and after the completion of treatment. Patients with comorbidity and patients without any comorbidity were compared by MANOVA and ANOVA with repeated measures. Results. The results of the study showed that 91% of patients met diagnostic criteria of comorbid psychiatric disorder and these patients had more severe clinical picture than patients without any comorbid disorder before the treatment. The results also showed that, after the completion of treatment, there was a significant reduction of all analyzed symptoms, that the effects of treatment were significantly better in patients with psychiatric comorbidity and that comorbid psychiatric disorders had no negative effect on the main goals of the treatment. Conclusion. Based on these results, it may be concluded that: in patients with panic disorder and agoraphobia and comorbid psychiatric disorders, the pharmacotherapy must be based on simultaneous use of antidepressants and benzodiazepines, while standard cognitive-behavior therapy of patients with panic disorder and agoraphobia must be modified in case of the existing comorbid psychiatric disorders.

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Comparison of Alprazolam and Cognitive Behavior Therapy in the Treatment of Panic Disorder: A Preliminary Report

Panic and Phobias 2 ◽

10.1007/978-3-642-73543-1_5 ◽

1988 ◽

pp. 54-65 ◽

Cited By ~ 8

Author(s):

J. S. Klosko ◽

D. H. Barlow ◽

R. B. Tassinari ◽

J. A. Cerny

Keyword(s):

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Preliminary Report ◽

Cognitive Behavior

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Affective Styles in Panic Disorder and Specific Phobia: Changes Through Cognitive Behavior Therapy and Prediction of Remission

Behavior Therapy ◽

10.1016/j.beth.2019.06.006 ◽

2020 ◽

Vol 51 (3) ◽

pp. 375-385

Author(s):

Christina Totzeck ◽

Tobias Teismann ◽

Stefan G. Hofmann ◽

Ruth von Brachel ◽

Xiao Chi Zhang ◽

...

Keyword(s):

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Specific Phobia ◽

Cognitive Behavior

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Efficacy of a combined therapy with imipramine and cognitive behavior therapy in the treatment of panic disorder

European Neuropsychopharmacology ◽

10.1016/0924-977x(93)90168-l ◽

1993 ◽

Vol 3 (3) ◽

pp. 378

Author(s):

W.H. Strauss ◽

M. Bruck ◽

C. Wurthmann ◽

E. Klieser

Keyword(s):

Panic Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Combined Therapy ◽

Cognitive Behavior

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