One-year follow-up of pharmacotherapy-resistant patients with panic disorder treated with cognitive-behavior therapy: Outcome and predictors of remission

• Published in: Behaviour research and therapy Vol. 44; no. 5; pp. 657 - 665
• Main Authors: Heldt, Elizeth, Gus Manfro, Gisele, Kipper, Leticia, Blaya, Carolina, Isolan, Luciano, Otto, Michael W.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.2006; Elsevier Science; Elsevier Science Ltd
• Subjects: Adult; Adult and adolescent clinical studies; Anti-Anxiety Agents - therapeutic use; Anxiety disorders. Neuroses; Behavior disorders; Behavior modification; Behavior therapy. Cognitive therapy; Biological and medical sciences; Co morbidity; Cognitive therapy; Cognitive Therapy - methods; Cognitive-behavior therapy; Combined Modality Therapy; Drug Resistance; Female; Follow-up; Follow-Up Studies; Group therapy; Humans; Male; Medical sciences; Middle Aged; Panic attacks; Panic disorder; Panic Disorder - drug therapy; Panic Disorder - therapy; Pharmacology; Prognosis; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy, Group; Treatment Outcome; Treatments; Cognitive-behavior therapy; Group therapy; Co morbidity; Panic disorder; Follow-up; Human; Panic; Treatment resistance; Cognitive therapy; Cognitive disorder; Anxiety disorder; Group psychotherapy; Chemotherapy; Treatment; Follow up study; Remission; Behavior therapy; Predictive factor
• ISSN: 0005-7967; 1873-622X
• DOI: 10.1016/j.brat.2005.05.003

Non-response to pharmacotherapy for panic disorder (PD) is a well-documented problem. However, little information exists to guide next-step strategies for these non-responders. In addition to pharmacologic augmentation strategies, several studies support the efficacy of cognitive-behavior therapy (CBT) for these patients, although data on long-term outcomes has been lacking. In this study, we provide one-year outcomes on a sample of 63 patients who completed group CBT for PD after failing to respond adequately to previous pharmacotherapy. Sustained significant benefit was found for all dimensional outcome scores, and nearly two-thirds of the sample met remission criteria. This occurred with reductions in medication use over the follow-up period. Negative predictors of remission status included comorbid dysthymia, social phobia, and generalized anxiety disorder. These results provide additional evidence for the efficacy of CBT for medication non-responders with PD.