Early intervention in panic: pragmatic randomised controlled
                        trial

Meulenbeek, Petrus Antonius Maria; Willemse, Godelief; Smit, Filip; Balkom, Anton van; Spinhoven, Philip; Cuijpers, Pim

doi:10.1192/bjp.bp.109.072504

Cited by 31 publications

(23 citation statements)

References 23 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For study design and intervention, our study is comparable with the trial of Meulenbeek et al [10]. That study found a moderate effect size of d =0.68 for the face-to-face group course Don’t Panic, an intervention with similar content to Don’t Panic Online.…”

Section: Discussionsupporting

confidence: 82%

“…Research indicates that it is also possible to prevent or delay the onset of clinical PD in people with subclinical panic symptoms [9,10]. A recent study showed that a group intervention involving primarily cognitive behavioral therapy effectively reduced symptoms in subclinical cases of PD, as well as in relatively mild cases [10]. This group course, called Don’t Panic, could also be acceptable from a cost-effectiveness point of view [11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

An Internet-Based Guided Self-Help Intervention for Panic Symptoms: Randomized Controlled Trial

Ballegooijen¹,

Riper²,

Klein³

et al. 2013

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

BackgroundInternet-based guided self-help is efficacious for panic disorder, but it is not known whether such treatment is effective for milder panic symptoms as well.ObjectiveTo evaluate the effectiveness of Don’t Panic Online, an Internet-based self-help course for mild panic symptoms, which is based on cognitive behavioral principles and includes guidance by email.MethodsA pragmatic randomized controlled trial was conducted. Participants (N=126) were recruited from the general population and randomized to either the intervention group or to a waiting-list control group. Inclusion criteria were a Panic Disorder Severity Scale-Self Report (PDSS-SR) score between 5-15 and no suicide risk. Panic symptom severity was the primary outcome measure; secondary outcome measures were anxiety and depressive symptom severity. Measurements were conducted online and took place at baseline and 12 weeks after baseline (T1). At baseline, diagnoses were obtained by telephone interviews.ResultsAnalyses of covariance (intention-to-treat) showed no significant differences in panic symptom reduction between groups. Completers-only analyses revealed a moderate effect size in favor of the intervention group (Cohen’s d=0.73, P=.01). Only 27% of the intervention group finished lesson 4 or more (out of 6). Nonresponse at T1 was high for the total sample (42.1%). Diagnostic interviews showed that many participants suffered from comorbid depression and anxiety disorders.ConclusionsThe Internet-based guided self-help course appears to be ineffective for individuals with panic symptoms. However, intervention completers did derive clinical benefits from the intervention.Trial RegistrationNederlands Trial Register: NTR1639; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1639 (Archived by WebCite at http://www.webcitation.org/6ITZPozs9).

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

An Internet-Based Guided Self-Help Intervention for Panic Symptoms: Randomized Controlled Trial

Ballegooijen¹,

Riper²,

Klein³

et al. 2013

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…The benefit of early intervention and prevention was highly valued for individuals with subthreshold GAD and other subthreshold psychiatric syndromes [16,67,68]. Clinical trials examining people with various types of subthreshold anxiety confirm this benefit.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review

et al. 2014

View full text Add to dashboard Cite

BackgroundTo review the prevalence and impact of generalized anxiety disorder (GAD) below the diagnostic threshold and explore its treatment needs in times of scarce healthcare resources.MethodsA systematic literature search was conducted until January 2013 using PUBMED/MEDLINE, PSYCINFO, EMBASE and reference lists to identify epidemiological studies of subthreshold GAD, i.e. GAD symptoms that do not reach the current thresholds of DSM-III-R, DSM-IV or ICD-10. Quality of all included studies was assessed and median prevalences of subthreshold GAD were calculated for different subpopulations.ResultsInclusion criteria led to 15 high-quality and 3 low-quality epidemiological studies with a total of 48,214 participants being reviewed. Whilst GAD proved to be a common mental health disorder, the prevalence for subthreshold GAD was twice that for the full syndrome. Subthreshold GAD is typically persistent, causing considerably more suffering and impairment in psychosocial and work functioning, benzodiazepine and primary health care use, than in non-anxious individuals. Subthreshold GAD can also increase the risk of onset and worsen the course of a range of comorbid mental health, pain and somatic disorders; further increasing costs. Results are robust against bias due to low study quality.ConclusionsSubthreshold GAD is a common, recurrent and impairing disease with verifiable morbidity that claims significant healthcare resources. As such, it should receive additional research and clinical attention.

show abstract

“…For instance, it would be important to identify people at high risk or in the early stages of psychosis, given that preliminary data have suggested that low doses of atypical antipsychotics associated with psychosocial interventions may delay the onset of psychosis in some individuals [63], and that early treatment with atypical antipsychotics may reduce the risk of transition to psychosis [64]. In addition, psychosocial interventions such as cognitive behavioral therapy and family interventions as well as close monitoring may be safer, more acceptable and more effective for at least a subgroup of patients in the early stages of psychosis [65], whereas patients with severe psychopathology at onset may benefit from an early intervention with low doses of second-generation antipsychotics [66]. The role of psychotherapy in its different forms should be better investigated in relation to DUP/DUI, in order to detect potential differences in efficacy between medications and psychotherapy or even against combined treatments.…”

Section: Resultsmentioning

confidence: 99%

Can Long-Term Outcomes Be Improved by Shortening the Duration of Untreated Illness in Psychiatric Disorders? A Conceptual Framework

et al. 2012

View full text Add to dashboard Cite

The duration of untreated illness (DUI), meaning the latency to the pharmacological treatment, has been increasingly investigated in the last decade as a predictor of outcome across different psychiatric conditions, particularly in psychotic disorders. DUI is essentially computed by subtracting the age of onset of a specific disorder from the age at which the first adequate pharmacological treatment is administered. Assessment of the latency to treatment represents one of the first steps in planning early interventions. This review examines the role of the DUI in psychotic and affective disorders, focusing on neuropathological, epidemiologic, clinical and prognostic factors related to a longer latency to treatment. Through a Medline and Cochrane Library search, relevant studies up to June 2011 and other pertinent articles including meta-analyses, randomized controlled trials, naturalistic studies and clinical reviews were identified. Converging evidence indicates that a prolonged DUI negatively influences the outcome of first-episode psychosis and schizophrenia in different ways, and increasing data point toward a similar conclusion in affective disorders. Even though methodological limitations related to investigation of the DUI need to be considered, research and interventions aimed to reduce latency to treatments are object of increasing implementation worldwide. The assessment of the DUI represents one of the most important parameters to consider in this perspective, in order to quantify different latency to treatment in specific disorders and to plan related, targeted interventions.

show abstract

Early intervention in panic: pragmatic randomised controlled trial

Abstract: People presenting with subthreshold and mild panic disorder benefit from this brief intervention.

Cited by 31 publications

References 23 publications

An Internet-Based Guided Self-Help Intervention for Panic Symptoms: Randomized Controlled Trial

An Internet-Based Guided Self-Help Intervention for Panic Symptoms: Randomized Controlled Trial

The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review

Can Long-Term Outcomes Be Improved by Shortening the Duration of Untreated Illness in Psychiatric Disorders? A Conceptual Framework

Contact Info

Product

Resources

About