Videoconference-delivered cognitive behavioral therapy (VCBT) may be an effective add-on treatment for people with panic disorder who don’t fully respond to medication, according to a study in BMC Psychiatry.Yoichi Seki, Ph.D., of Chiba University in Japan, and colleagues examined data from 30 adults with panic disorder who still had at least moderate symptoms (as determined by a score of eight or higher on the Panic Disorder Severity Scale, or PDSS) after an initial treatment course with medications such as antidepressants or anxiolytics—either due to non-response or discontinuation because of side effects. The participants all had agoraphobia, as well.
The researchers randomized participants to receive usual care or usual care plus VCBT for 16 weeks. Usual care consisted of continued medication treatment by a primary care physician, while VCBT included psychoeducation, role-playing to reduce safety behaviors, training participants to shift their attention, and behavioral experiments to test participants’ negative beliefs.
At 16 weeks, PDSS scores dropped a mean of 7.92 points in the VCBT group while rising .75 points in the usual care group. Overall, 66.7% of participants receiving VCBT were in remission (with a PDSS score less than eight) at week 16, whereas no participants receiving usual care were in remission.
In addition, the VCBT group had statistically greater improvements in both agoraphobia symptoms and overall quality of life at week 16. There were no statistically significant differences between groups in depression or general anxiety symptoms after 16 weeks, but the researchers noted both of these were relatively low in both groups at baseline.
Seki and colleagues noted that in-person CBT is often inaccessible in Japan owing to a shortage of therapists and regional imbalances. They wrote: “It may also be difficult for patients with [panic disorder] and agoraphobia, who often have difficulty leaving the house, to attend weekly face-to-face CBT at outpatient clinics. VCBT could contribute to increasing treatment options for patients with [panic disorder] who remain symptomatic after primary pharmacotherapy.”
For related information, see the Psychiatric News article “Computer-Assisted CBT May Help Alleviate Depression.”
(Image: Getty Images/iStock/Wiphop Sathawirawong)
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