Quality of Life and Treatment Outcome in Panic Disorder: Cognitive Behavior Group Therapy Effects in Patients Refractory to Medication Treatment

Abstract

Background: Improvements in quality of life (QoL) as well as symptomatic relief are important outcomes for the treatment of panic disorder (PD). The aim of this study is to assess the impact of brief cognitive behavior group therapy (CBGT) for panic disorder on QoL and to identify the clinical features associated with these changes. Methods: Thirty-six patients with PD refractory to pharmacological treatment took part in a treatment protocol consisting of 12 sessions of CBGT. To evaluate the changes in QoL, the WHOQOL-bref was administered before and after treatment. Results: Thirty-two patients completed the treatment. Significant improvement in all domains of QoL was observed (p< 0.001), which was associated with reductions in general and anticipatory anxiety (p = 0.018) and agoraphobic avoidance (p = 0.046). Consistent with previous findings, associations between QoL and panic-free status did not reach significance in this small study (p = 0.094). Conclusions: CBGT was efficacious in the treatment of PD; the symptoms of anticipatory anxiety and avoidance appear to be more important than episodic panic episodes in affecting QoL.

Terapia cognitivo-comportamental no transtorno de pânico

“…CBT offered in either an individual or group setting has been shown to benefit these patients for both short-and long-term outcomes. 6,41 Treatment outcome studies of PD have provided a complex picture regarding the value of combination treatment. 16 Some researches suggest at least minimal additive treatment effects when CBT and medications are combined.…”

“…1 The course of PD tends to be chronic in the majority of patients, 2,3 and PD is associated with a reduced quality of life and impaired psychosocial functioning. [4][5][6] As compared to the other anxiety disorders, the onset of PD is frequently later, occurring in the late twenties on average. 7 PD affects two to three times more women than men, and may affect up to 3.5% of the population throughout life.…”

“…10,18 The effect size found for therapeutic response ranges between 0.6-2.3, depending on the dimension being evaluated. 6,19 CBT for PD is also associated with improvements in comorbid conditions and quality of life. 20,21 Heldt et al, in a study of 32 patients, demonstrated that reducing the symptoms of anticipatory anxiety and avoidance are more important for improving quality of life than changes in the frequency of panic attacks.…”

“…20,21 Heldt et al, in a study of 32 patients, demonstrated that reducing the symptoms of anticipatory anxiety and avoidance are more important for improving quality of life than changes in the frequency of panic attacks. 6 This article aims at describing the use of CBT for patients with PD, focusing on the nature of the disorder, the interventions used in CBT, and the outcome expected with this treatment modality. To do so, a literature review was performed searching Medline, SciELO and PsycInfo databases for references of the main articles found and also for specialized textbooks.…”

Elektronisches Routine-Outcome-Monitoring (eROM) in Psychiatrie und klinischer Psychologie

“…Im Bereich der wissenschaftlichen Forschung werden PROs zur Evaluation von Behandlungsmodalitäten, Psychopharmakatherapien [7][8][9] oder psychologischen und psychotherapeutischen Interventionen eingesetzt [10,11].…”