Effectiveness of brief cognitive behavior therapy on symptoms severity in relation to social avoidance among patients with panic disorder: a randomized controlled trial

Published: 13 November 2023
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Background. Panic disorder is a debilitating condition characterized by severe symptoms and social avoidance. Due to insufficient knowledge, this study examined the effectiveness of brief cognitive behavioral therapy (CBT) on symptom severity and social avoidance in patients with panic disorder. Patients and Methods. In this randomized controlled trial (RCT), 44 patients were included in the Brief CBT group or the control group after addressing issues related to lost-to-follow-up. Panic disorder symptom severity (PDSS) and the work and social adjustment scale (WSAS) were used to assess symptom severity and social adjustment, respectively. Results. After one month of treatment, the total PDSS scores (1.79 vs. 4.47; P=0.0409) and WSAS scores (2.97 vs. 7.41; P=0.0015) in the brief CBT group were significantly lower compared to the control group. The study revealed that in the brief CBT group, the mean score of PDSS and WSAS significantly decreased from 21.53 to 1.79 (P<0.0001) and from 24.63 to 2.95 (P<0.0001), and in the control group from 19.59 to 4.47 (P<0.0001) in PDSS and from 22.18 to 7.41 (P<0.0001) in WSAS, respectively. Furthermore, the change in WSAS scores in the brief CBT group was independent of the decrease in PDSS. Conclusions. This study demonstrated that the application of brief CBT is an effective technique for reducing symptom severity and social avoidance in patients with panic disorder.

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Pompoli A, Furukawa TA, Imai H, et al. Psychological therapies for panic disorder with or without agoraphobia in adults: a network meta-analysis. Cochrane Database Syst Rev 2016;4:CD011004. DOI: https://doi.org/10.1002/14651858.CD011004.pub2
Kristensen P, Weisæth L, Hussain A, et al. Prevalence of psychiatric disorders and functional impairment after loss of a family member: A longitudinal study after the 2004 Tsunami. Depress Anxiety 2015;32:49-56. DOI: https://doi.org/10.1002/da.22269
Baxter AJ, Vos T, Scott KM, et al. The global burden of anxiety disorders in 2010. Psychol Med 2014;44:2363-74. DOI: https://doi.org/10.1017/S0033291713003243
Batelaan N, Smit F, de Graaf R, et al. Economic costs of full-blown and subthreshold panic disorder. J Affect Disord 2007;104:127-36. DOI: https://doi.org/10.1016/j.jad.2007.03.013
Bystritsky A, Khalsa SS, Cameron ME, et al. Current diagnosis and treatment of anxiety disorders. Pharm Ther 2013;38:30.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5: American psychiatric association Washington, DC, 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596
De Jonge P, Roest AM, Lim CC, et al. Cross-national epidemiology of panic disorder and panic attacks in the world mental health surveys. Depress Anxiety 2016;33:1155-77. DOI: https://doi.org/10.1002/da.22572
Xiong P, Liu M, Liu B, et al. Trends in the incidence and DALYs of anxiety disorders at the global, regional, and national levels: Estimates from the Global Burden of Disease Study 2019. J Affect Disord 2022;297:83-93. DOI: https://doi.org/10.1016/j.jad.2021.10.022
Alhasnawi S, Sadik S, Rasheed M, et al. The prevalence and correlates of DSM-IV disorders in the Iraq Mental Health Survey (IMHS). World Psychiatry 2009;8:97.
Craske MG, Kircanski K, Epstein A, et al. Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V. Depress Anxiety 2010;27:93-112. DOI: https://doi.org/10.1002/da.20654
Livermore N, Sharpe L, McKenzie D. Panic attacks and panic disorder in chronic obstructive pulmonary disease: a cognitive behavioral perspective. Respir Med 2010;104:1246-53. DOI: https://doi.org/10.1016/j.rmed.2010.04.011
White KS, Brown TA, Somers TJ, et al. Avoidance behavior in panic disorder: The moderating influence of perceived control. Behav Res Ther 2006;44:147-57. DOI: https://doi.org/10.1016/j.brat.2005.07.009
De Beurs E, Beekman A, Van Balkom A, et al. Consequences of anxiety in older persons: its effect on disability, well-being and use of health services. Psychol Med 1999;29:583-93. DOI: https://doi.org/10.1017/S0033291799008351
Simos G, Hofmann SG. CBT for anxiety disorders: A practitioner book: John Wiley & Sons, 2013. DOI: https://doi.org/10.1002/9781118330043
Gosch EA, Flannery-Schroeder E, Mauro CF, et al. Principles of cognitive-behavioral therapy for anxiety disorders in children. J Cogn Psychother 2006;20:247-62. DOI: https://doi.org/10.1891/jcop.20.3.247
Schwartze D, Barkowski S, Strauss B, et al. Efficacy of group psychotherapy for panic disorder: Meta-analysis of randomized, controlled trials. Group Dyn Theor Res Pract 2017;21:77. DOI: https://doi.org/10.1037/gdn0000064
Mangolini VI, Andrade LH, Lotufo-Neto F, et al. Treatment of anxiety disorders in clinical practice: a critical overview of recent systematic evidence. Clinics 2019;74:e1316. DOI: https://doi.org/10.6061/clinics/2019/e1316
Deacon B, Abramowitz J. A pilot study of two-day cognitive- behavioral therapy for panic disorder. Behav Res Ther 2006;44:807-17. DOI: https://doi.org/10.1016/j.brat.2005.05.008
Westling BE, Öst L-G. Brief cognitive behaviour therapy of panic disorder. Scand J Behav Ther 1999;28:49-57. DOI: https://doi.org/10.1080/028457199440007
Evans L, Holt C, Oei TP. Long term follow-up of agoraphobics treated by brief intensive group cognitive behavioural therapy. Aust N Z J Psychiatry 1991;25:343-9. DOI: https://doi.org/10.3109/00048679109062635
Lim J-A, Lee YI, Jang JH, et al. Investigating effective treatment factors in brief cognitive behavioral therapy for panic disorder. Medicine 2018;97. DOI: https://doi.org/10.1097/MD.0000000000012422
Houck PR, Spiegel DA, Shear MK, et al. Reliability of the self-report version of the panic disorder severity scale. Depress Anxiety 2002;15:183-5. DOI: https://doi.org/10.1002/da.10049
Mundt JC, Marks IM, Shear MK, et al. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry 2002;180:461-4. DOI: https://doi.org/10.1192/bjp.180.5.461
Alhakem SSM. The effectiveness of short-term intensive cognitive-behavioral therapy on symptoms severity of patients with panic disorder. Duhok Med J 2019;13:44-55. DOI: https://doi.org/10.31386/dmj.2019.13.1.5
Deacon B. Two-day, intensive cognitive-behavioral therapy for panic disorder: a case study. Behav Modif 2007;31:595-615. DOI: https://doi.org/10.1177/0145445507300873
Schmidt NB, Woolaway-Bickel K, Trakowski J, et al. Dismantling cognitive–behavioral treatment for panic disorder: questioning the utility of breathing retraining. J Cons Clin Psychol 2000;68:417. DOI: https://doi.org/10.1037/0022-006X.68.3.417
Antony MM, Swinson RP. Phobic disorders and panic in adults: a guide to assessment and treatment: American Psychological Association, 2000. DOI: https://doi.org/10.1037/10348-000
Barlow DH, Craske MG. Mastery of your anxiety and panic: Oxford University Press, 2006. DOI: https://doi.org/10.1093/med:psych/9780195311358.001.0001
Rapee RM. Descriptive psychopathology of social phobia. In Heimberg RG, Liebowitz MR, Hope DA, Schneier FR (Eds.), Social phobia: Diagnosis, assessment, and treatment. The Guilford Press, 1995;41-66.
Powers MB, Smits JA, Leyro TM, et al. Translational research perspectives on maximizing the effectiveness of exposure therapy. Handbook of exposure therapies 2007:109-26. DOI: https://doi.org/10.1016/B978-012587421-2/50005-3
Foa EB, Kozak MJ. Emotional processing of fear: exposure to corrective information. Psychol Bull 1986;99:20. DOI: https://doi.org/10.1037/0033-2909.99.1.20
Norton G, McLeod L, Guertin J, et al. Panic disorder or social phobia: which is worse? Behav Res Ther 1996;34:273-6. DOI: https://doi.org/10.1016/0005-7967(95)00066-6
Singh P, Samantaray NN. Brief Cognitive behavioral group therapy and verbal-exposure-augmented cognitive behavioral therapy for social anxiety disorder in university students: a randomized controlled feasibility trial. Indian J Psychol Med 2022;44:552-7. DOI: https://doi.org/10.1177/02537176211026250
Hecker JE, Losee MC, Roberson-Nay R, et al. Mastery of your anxiety and panic and brief therapist contact in the treatment of panic disorder. J Anxiety Disord 2004;18:111-26. DOI: https://doi.org/10.1016/S0887-6185(02)00241-4

How to Cite

Piro, R. S., & Taha, P. H. (2023). Effectiveness of brief cognitive behavior therapy on symptoms severity in relation to social avoidance among patients with panic disorder: a randomized controlled trial. Italian Journal of Medicine, 17(3). https://doi.org/10.4081/itjm.2023.1664