Comparison of Psychotherapy Programs to Treat Panic Disorder

Weill Cornell Medicine (WCM)

Status and phase: Completed; Phase 3

Conditions: Panic Disorder; Agoraphobia; Anxiety Disorders

Treatments: Behavioral: Applied relaxation training (ART); Behavioral: Panic focused psychodynamic psychotherapy (PFPP); Behavioral: Cognitive behavioral therapy

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT00353470

R01MH070918

R01MH070664 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study will determine the relative effectiveness of three psychotherapies in treating people with a panic disorder.

Full description

Panic disorder (PD) is a debilitating anxiety disorder. It is characterized by unexpected and repeated episodes of intense fear, accompanied by serious physical symptoms, such as chest pain, heart palpitations, shortness of breath, dizziness, or abdominal stress. Available treatments for PD include medication therapy and cognitive behavioral therapy (CBT), a type of psychotherapy that teaches people how to view panic attacks differently and how to reduce anxiety. Approximately 30% of patients refuse medication, however, and nearly 50% do not achieve remission with CBT alone. Therefore, there is a pressing need for additional non-pharmacologic treatment methods. Panic-focused psychodynamic psychotherapy (PFPP) and applied relaxation training (ART) are among some of the other available treatments for PD. During ART, individuals are taught to relax their muscles while being exposed to increasingly frightening situations. PFPP combines elements of CBT with other, more extensive approaches aimed at determining the anxiety's origin and at finding ways to reduce it. This study will compare the effectiveness of PFPP, CBT, and ART in treating PD.

Participants in this single blind study will be randomly assigned to receive PFPP, CBT, or ART for 12 weeks. All participants will attend between 19 and 24 treatment sessions over the course of the study. Upon completing the study, participants will attend monthly follow-up visits for an additional 12 months. Participants assigned to ART who have not responded by the end of treatment may opt to receive PFPP or CBT. Outcomes will be assessed using a variety of scales to determine depression and anxiety symptoms.

Enrollment: 201 patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Meets DSM-IV diagnosis criteria for primary PD with or without agoraphobia
• History of at least one spontaneous panic attack per week within the month prior to study entry

Exclusion criteria

• Active substance dependence within 6 months prior to study entry
• Lifetime history of any psychotic disorder, including bipolar disorder
• Acutely suicidal

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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201 participants in 3 patient groups

1

Experimental group

Description:

Participants will receive panic focused psychodynamic psychotherapy for 12 weeks

Treatment:

Behavioral: Panic focused psychodynamic psychotherapy (PFPP)

2

Active Comparator group

Description:

Participants will receive cognitive behavioral therapy-panic control treatment for 12 weeks

Treatment:

Behavioral: Cognitive behavioral therapy

3

Active Comparator group

Description:

Participants will receive applied relaxation training for 12 weeks

Treatment:

Behavioral: Applied relaxation training (ART)