The Bergen 4-day treatment for panic disorder: replication and implementation in a new clinic

Abstract

Background Bergen 4-day treatment (B4DT) is a concentrated exposure-based treatment (cET), where the patient receives concentrated, individually tailored cognitive behavioral therapy (CBT) during four consecutive days. Previous findings have indicated that B4DT could be a promising treatment for panic disorder (PD). Aim The aim of the present study was to evaluate the implementation of B4DT for panic disorder with- and without agoraphobia, at a new clinic. This is the first replication study for B4DT on panic disorder. Method Thirty consecutively recruited patients with PD were included in an open trial design. Assessment of symptoms of panic disorder were measured with Panic Disorder Severity Scale (PDSS), while symptoms of generalized anxiety were assessed by Generalized Anxiety Disorder-7 (GAD-7) and depressive symptoms by Patient Health Questionnaire (PHQ-9) pre-treatment, post-treatment and at 3-month follow-up. Treatment satisfaction was measured with Client Satisfaction Questionnaire (CSQ-8) post-treatment. Results The results showed a significant reduction in symptom severity from pre-treatment to post-treatment (d = 4.32), and at 3-month follow-up (d = 4.91). The proportion of patients classified as fulfilling the criteria for remission was 80.0% at post-treatment and 86.7% at follow up. There was a significant reduction in symptoms of depression and generalized anxiety. Treatment satisfaction was high and none of the patients dropped out. Conclusion The current study replicated the results from the original study and indicate that the treatment can be successfully implemented at new clinics. B4DT may be a promising treatment for panic disorder and comorbid symptoms of generalized anxiety and depression. Larger and more controlled studies are needed to establish the efficacy of B4DT for panic disorder.

The Bergen 4-day treatment for panic disorder: implementation in a rural clinical setting

“…Compared to patients receiving standard CBT, patients in this study had significantly higher scores pretreatment (see Table 4 ). This is in line with previous studies on the B4DT [ 16 , 17 ] indicating that patients offered the B4DT may generally have higher PD severity than the average PD patient in other studies. Compared with standard CBT studies, the current study also found significantly lower scores at posttreatment and at the 3-month follow-up, which is also in line with previous studies on the B4DT for PD [ 16 , 17 ].…”

“…This is in line with previous studies on the B4DT [ 16 , 17 ] indicating that patients offered the B4DT may generally have higher PD severity than the average PD patient in other studies. Compared with standard CBT studies, the current study also found significantly lower scores at posttreatment and at the 3-month follow-up, which is also in line with previous studies on the B4DT for PD [ 16 , 17 ]. The comparison with standard CBT should be interpreted with caution, as the effect size can differ due to different study designs.…”

“…Compared to the replication study, the current study showed significantly lower PDSS scores at pretreatment ( p < .001, d = 1.01). The results of the current study did not differ significantly from those of the replication study at posttreatment ( p = .62, d = 0.10) or at the 3-month follow-up ( p = .82, d = 0.05) [ 17 ].…”

“…A replication study found similar results among 30 patients with PD treated in a new clinical setting in a medium-sized Norwegian city [ 17 ]. At posttreatment, 80% were in remission, and the results were stable at the 3-month follow-up (86% in remission).…”

“…Regarding treatment satisfaction, there was no significant difference between the current study and the pilot study ( p = .16, d = 0.29) [ 16 ]. There was a significantly lower score in treatment satisfaction in this study compared to that in the replication study ( p = .005, d = 0.66) [ 17 ].…”