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Evidence-based Treatment of Panic Disorder

Abstract

Panic disorder is an anxiety disorder characterized by the presence of autonomic arousal symptoms in unexpected situations (panic attacks), which are accompanied by anticipatory anxiety regarding possible future attacks. Its prevalence rate is reported to be 1–4% worldwide and it ranks 11th among all diseases in terms of years lived with disability. Numerous studies have been conducted in the past 30 years and empirically validated cognitive behavior therapy for panic disorder has been developed based on the results of such studies. To this end, this review will focus on providing a brief clinical description and etiology of panic disorder, followed by an overview of the specific nature of evidence-based treatment for panic disorder. What are the core components of evidence-based treatment for panic disorder according to Korean and foreign treatment effectiveness studies and/or meta-analyses? What are the moderating or mediating factors that affect treatment effectiveness and outcomes? Furthermore, this review will summarize the current status of the effectiveness of computer- and internetbased treatment programs for panic disorder. Finally, a summary of treatment guidelines for panic disorder will be provided based on the treatment guidelines recommended by different related disciplines and organizations.

keywords
근거기반치료, 심리장애, 공황장애, evidence-based treatment, psychological disorders, panic disorder

Reference

1.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

2.

Andrews, G., Cuijpers, P., Craske, M. G., McEvoy, P., & Titov, N. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: A metaanalysis. PloS ONE, 5, e13196.

3.

Antony, M. M., & Rowa, K. (2005). Evidence-based assessment of anxiety disorders in adults. Psychological Assessment, 17, 256-266.

4.

Bandelow, B., Reitt, M., Rover, C., Michaelis, S., Gorlich, Y., & Wedekind, D. (2015). Efficacy of treatments for anxiety disorders: A meta-analysis. International Clinical Psychopharmacology, 30, 183-192.

5.

Barlow, D. H. (1988). Anxiety and its disorders. New York: Guilford.

6.

Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.

7.

Barlow, D. H., & Craske, M. (2016). Mastery of your anxiety and panic: Workbook (B. H. Choi, Trans.). Seoul: Sigma Press.

8.

Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & Ehrenreich-May, J. (2010). Unified protocol for transdiagnostic treatment of emotional disorders: Workbook (Y. R. Cho, S. S. Noh, M. K. Choi, Trans.). Seoul: Hakjisa.

9.

Barlow, D. H., Gorman, J. M., Shear, M. K., & Woods, S. W. (2000). Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. JAMA, 283, 2529-2536.

10.

Barlow, D. H., & Kennedy, K. A. (2016). New approaches to diagnosis and treatment in anxiety and related emotional disorders:A focus on temperament. Canadian Psychology, 57, 8-20.

11.

Barlow, D. H., Pincus, D. B., Heinrichs, N., & Choate, M. A. (2003). Anxiety disorders. In G. S. Stricker & T. A. Widiger (Eds.), Handbook of psychology, Vol. 8: Clinical psychology (pp. 119-147). New York: Wiley & Sons.

12.

Barlow, D. H., Raffa, S. D., & Cohen, E. M. (2002). Psychosocial treatments for panic disorders, phobias, and generalized anxiety disorder. In P. E. Nathan & J. M. Gorman (Eds.), A guide to treatments that work (pp. 351-394). London: Oxford University Press.

13.

Barlow, D. H., Sauer-Zavala, S., Carl, J. R., Bullis, J. R., & Ellard, K. K. (2014). The nature, diagnosis, and treatment of neuroticism:Back to the future. Clinical Psychological Science, 2, 344-365.

14.

Boswell, J. F., Gallagher, M. W., Sauer-Zavala, S. E., Bullis, J., Farchione, T. J., & Barlow, D. H. (2013). Patient characteristics and variability in adherence and competence in cognitive-behavioral therapy for panic disorder. Journal of Consulting and Clinical Psychology, 81, 443-454.

15.

Bouton, M. E., Mineka, S., & Barlow, D. H. (2001). A modern learning theory perspective on the etiology of panic disorder. Psychological Review, 108, 4-32.

16.

Briggs, A. C., Stretch, D. D., & Brandon, S. (1993). Subtyping of panic disorder by symptom profile. British Journal of Psychiatry, 163, 201-209.

17.

Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, R. J., & Mancill, K. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110, 585-599.

18.

Bullis, J. R., Fortune, M. R., Farchione, T. J., & Barlow, D. H. (2014). A preliminary investigation of the long-term outcome of the unified protocol for transdiagnostic treatment of emotional disorders. Comprehensive Psychiatry, 55, 1920-1927.

19.

Butler, A., Chapman, J., Formance, E., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17-31.

20.

Chae, J. H., Ahn, H. W., Lee, J. J., Bahk, W. M., Jun, T. Y., & Kim, K. S. (1999). Short-term effect of combined cognitive-behavioral therapy with pharmacotherapy for panic disorder. The Korean Journal of Psychopathology, 8, 168-174.

21.

Choi, Y. H. (2004). Comparison of the effectiveness between combined therapy and pharmacotherapy for panic disorder. Cognitive Behavior Therapy in Korea, 4, 73-83.

22.

Choi, Y. H., Choi, Y. J., Park, K. H., & Woo, J. M. (2002). Impact of group cognitive behavioral therapy on quality of life in patients with panic disorder. Journal of the Korean Neuropsychiatric Association, 41, 1120-1129.

23.

Choi, Y. H.,Choi, Y. J., Woo, J. M., & Yoon, H. Y. (2006). A comparison study of treatment outcome in panic disorder with or with out agoraphobia. Cognitive Behavior Therapy in Korea, 6, 163-178.

24.

Choi, Y. H., Kim, G. M., Park, K. H., & Yoon, H. Y. (2003). The effects of cognitive behavioral therapy for discontinuation of medication in panic disorder. Korean Journal of Psychopharmacology, 14, 367-376.

25.

Choi, Y. H., Park, K. H., Kim, H. S., & Ha, O. R. (2000). Predicting factors of discontinuation of medication after cognitive behavioral therapy for pain disorder. Korean Journal of Biological Psychiatry, 7, 186-190.

26.

Choi, Y. H., Park, K. H., Woo, Y. J., & Yoon, H. Y. (2003). 12 months follow-up study of group cognitive behavioral therapy for panic disorder. Korean Journal of Psychosomatic Medicine, 11, 205-213.

27.

Choi, Y. H., Vincelli, F., Riva, G., Wiederhold, B. K., Lee, J. H., & Park, K. H. (2005). Effects of group experiential cognitive therapy for the treatment of panic disorder with agoraphobia. Cyber-Psychology and Behavior, 8, 387-393.

28.

Choi, Y. S., Lee, E. J., & Cho, Y. (2017). The effect of Korean-group cognitive behavioural therapy among patients with panic disorder in clinic settings. Journal of Psychiatric and Mental Health Nursing, 24, 28-40.

29.

Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461-470.

30.

Craske, M. C., Meadows, E., & Barlow, D. H. (1994). Therapist guide for the mastery of your anxiety and panic II and agoraphobia supplement. Albany, NY: Graywind Publications.

31.

Craske, M. C., Rose, R. D., Lang, A., Welch, S. S., Campbell-Sills, L., Sullivan, G., . . . Roy-Byrne, P. P. (2009). Computer-assisted delivery of cognitive behavioral therapy for anxiety disorders in primary-care settings. Depression and Anxiety, 26, 235-242.

32.

Cuijpers, P., Marks, I. M., van Straten, A., Cavanagh, K., Gega, L., & Andersson, G. (2009). Computer-aided psychotherapy for anxiety disorders: A meta-analytic review. Cognitive Behavior Therapy, 38, 66-82.

33.

Executive Committee for Korean Medication Algorithm for Panic Disorder. (2008). Korean medication algorithm project for panic disorder 2008. Seoul: ML Communication.

34.

Freire, R. C. (2017, May). Panic attacks induced by computer simulation in patients with panic disorder and agoraphobia. Paper presented at the annual American Psychiatric Association Meeting, San Diego, CA.

35.

Gardenswartz, C., & Craske, M. (2001). Prevention of panic disorder. Behavior Therapy, 32, 725-737.

36.

Hendriks, G. J., Kampman, M., Keijsers, G. P. J., Hoogduin, C. A. L., & Voshaar, R. C. O. (2014). Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: A comparison with younger patients. Depression and Anxiety, 31, 669-677.

37.

Heuzenroeder, L., Donnelly, M., Haby, M. M., Mihalopoulos, C., Rossell, R., Carter, R.,. . . Vos, T. (2004). Cost-effectiveness of psychological and pharmacological interventions for generalized anxiety disorder and panic disorder. Australian and New Zealand Journal of Psychiatry, 38, 602-612.

38.

Hoffman, E. C., & Mattis, S. G. (2000). A developmental adaptation of panic control treatment for panic disorder in adolescence. Cognitive and Behavioral Practice, 7, 253-261.

39.

Hofmann, S. G., Meuret, A. E., Rosenfield, D., Suvak, M. K., Barlow, D. H., Gorman, J. M.,. . .Woods, S. W. (2007). Preliminary evidence for cognitive mediation during cognitive-behavioral therapy of panic disorder. Journal of Consulting and Clinical Psychology, 75, 374-379.

40.

Hofmann, S. G., & Smits, J. A. J. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69, 621-632.

41.

Hofmann, S. G., & Spiegel, D. A. (1999). Panic control treatment and its applications. Journal of Psychotherapy Practice and Research, 8, 3-11.

42.

Huh, Y. J., Choi, Y. H., & Park, K. H. (2003). Therapeutic factors of group cognitive behavioral therapy for panic disorder. Cognitive Behavior Therapy in Korea, 3, 57-67.

43.

Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., & Van Ameringen, M. (2014). Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders. BMC Psychiatry, 14(1), S1.

44.

Kenardy, J. A., Dow, M. G., Johnston, D. W., Newman, M. G., Thomson, A., & Taylor, C. B. (2003). A comparison of delivery methods of cognitive behavioral therapy for panic disorder: An international multi-center trial. Journal of Consulting and Clinical Psychology, 71, 1068-1075.

45.

Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.

46.

Kessler, R. C., Ruscio, A. M., Shear, K., & Wittchen, H. U. (2010). Epidemiology of anxiety disorders. Current Topics in Behavioral Neuroscience, 2, 21-35.

47.

Kim, B. N., & Kim, J. H. (2015). Basic concepts of evidence-based assessment (EBA) and discussion for its application in Korea:With examples of panic disorder and depression. Korean Journal of Clinical Psychology, 34, 579-605.

48.

Kim, H. S., & Kim, E. J. (2015). Meta-analysis of the effects of nonpharmacological interventions for anxiety disorder. Journal of the Korea Academia-Industrial Cooperation Society, 16, 7273-7284.

49.

Kim, J. B. (1999). Cognitive-behavioral group therapy for patients with panic disorder with agoraphobia and 6-month follow-up. Journal of the Korean Society of Biological Therapies in Psychiatry, 5, 1-10.

50.

Kim, W. Y., Lee, S. H., Choi, T. K., Suh, S. Y., Kim, B., Kim, C. M.,. . . Yook, K. H. (2009). Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Depression and Anxiety, 26, 601-606.

51.

Lee, S. H., Yang, J. C., Yoon, S. C., Suh, H. S., Kim, C. H., Yu, B. H., & Park, M. S. (2008). Development of the medication algorithm for panic disorder (3): Cognitive behavioral therapy. Anxiety and Mood, 4, 28-33.

52.

Liebowitz, M. R. (1997). Panic disorder as a chronic illness. Journal of Clinical Psychiatry, 58, 5-8.

53.

Marchand, A., Roberge, P., Primiano, S., & Germain, V. (2009). A randomized, controlled clinical trial of standard, group and brief cognitive-behavioral therapy for panic disorder with agoraphobia:A two-year follow-up. Journal of Anxiety Disorders, 23, 1139-1147.

54.

Martin, H. V., Botella, C., Garcia-Palacios, A., & Osma, J. (2007). Virtual reality exposure in the treatment of panic disorder with agoraphobia: A case study. Cognitive and Behavioral Practice, 14, 58-69.

55.

Mitte, K. (2005). A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia. Journal of Affective Disorders, 88, 27-45.

56.

National Institute for Health and Clinical Excellence (NICE). (2011). Anxiety: Management of anxiety (panic disorder, with or without agoraphobia, and generalized anxiety disorder) in adults in primary, secondary and community care. London: The British Psychological Society and The Royal College of Psychiatrists. Retrieved from http://www.nice.org.uk

57.

Oldthuis, J. V., Watt, M. C., Bailey, K., & Hayden, J. A. (2015). Therapist-supported internet cognitive behavioural therapy for anxiety disorders in adults. Cochrane Database Systematic Review, 5, CD011565.

58.

Öst, L. G. (2008). Cognitive behavior therapy for anxiety disorders:40 years of progress. Nordic Journal of Psychiatry, 62, 5-10.

59.

Otto, M. W., & Deveney, C. (2005). Cognitive-behavior therapy vs. exposure in vivo in the treatment of panic disorder with agoraphobia. Behaviour Research and Therapy, 42, 1105-1127.

60.

Otto, M. W., & Pollack, M. H. (2009). Stopping anxiety medication. Therapist guide (2nd ed.). New York: Oxford University Press.

61.

Otto, M. W., Tolin, D. F., Simon, N. M., Pearlson, G. D., Basden, S., Meunier, S. A., . . . Pollack, M. H. (2009). The efficacy of d-cycloserine for enhancing response to cognitive-behavior therapy for panic disorder. Biological Psychiatry, 67, 365-370.

62.

Park, E. Y., Choi, Y. H., Park, K. H., & Kwon, J. H. (2001). The study on the relationship among the expectancy of treatment, the evaluation of therapist and the therapeutic effect of cognitive behavioral therapy of panic disorder. Cognitive Behavior Therapy in Korea, 1, 67-76.

63.

Porter, E., & Chambless, D. L. (2015). A systematic review of predictors and moderators of improvement in cognitive-behavioral therapy for panic disorder and agoraphobia. Clinical Psychology Review, 42, 179-192.

64.

Reger, M. A., & Gahm, G. A. (2009). A meta-analysis of the effects of internet- and computer-based cognitive-behavioral treatments for anxiety. Journal of Clinical Psychology, 65, 53-75.

65.

Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141-153.

66.

Roth, W. T. (2010). Diversity of effective treatments of panic attacks:What do they have in common? Depression and Anxiety, 27, 5-11.

67.

Roth, W. T., Wilhelm, F. H., & Pettit, D. (2005). Are current theories of panic disorder falsifiable? Psychological Bulletin, 131, 171-192.

68.

Roy-Byrne, P. P., Craske, M. G., & Stein, M. B. (2006). Panic disorder. Lancet, 368, 1023-1032.

69.

Roy-Byrne, P. P., Craske, M. G., Stein, M. B., Sullivan, G. Bystritsky, A., Katon, W., . . . Sherbourne, C. D. (2005). A randomized effectiveness trial of cognitive-behavioral therapy and medication for primary care panic disorder. Archives of General Psychiatry, 62, 290-298.

70.

Sánchez-Meca, J., Rosa-Alcázar, A. I., Marín-Martínez, F., & Gómez- Conesa, A. (2010). Psychological treatment of panic disorder with or without agoraphobia: A meta-analysis. Clinical Psychology Review, 30, 37-50.

71.

Schmidt, N. B., & Keough, M. E. (2010). Treatment of panic. Annual Review of Clinical Psychology, 6, 241-256.

72.

Schmidt, N. B., Woolaway-Bickel, K., Trakowski, J., Santiago, H., Storey, J., Koselka, M., & Cook, J. (2000). Dismantling cognitivebehavioral treatment for panic disorder: Questioning the utility of breathing retraining. Journal of Consulting and Clinical Psychology, 68, 417-424.

73.

Schwartze, D., Barkowski, S., Strauss, B., Burlingame, G. M., Barth, J., & Rosendahl, J. (2017). Efficacy of group psychotherapy for panic disorder: Meta-analysis of randomized, controlled trials. Group Dynamics: Theory, Research, and Practice, 21, 77-93.

74.

Seo, H. J., Lee, K. S., Lee, S. H., & Suh, H. S. (2016). Recent advances in cognitive behavioral therapy for panic disorder. Anxiety and Mood, 12, 47-55.

75.

Smits, J. A., Berry, A. C., Tart, C. D., & Powers, M. B. (2008). The efficacy of cognitive-behavioral interventions for reducing anxiety sensitivity: A meta-analytic review. Behaviour Research and Therapy, 46, 1047-1054.

76.

Smits, J. A., Powers, M. B., Cho, Y., & Telch, M. J. (2004). Mechanism of change in cognitive-behavioral treatment of panic disorder:Evidence for the fear of fear mediational hypothesis. Journal of Consulting and Clinical Psychology, 72, 646-652.

77.

Toni, C., Perugi, G., Frare, F., Mata, B., Vitale, B., Mengali, F., … Akiskal, H. S. (2000). A prospective naturalistic study of 326panic-agoraphobic patients treated with antidepressants. Pharmacopsychiatry, 33, 121-131.

78.

Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Uqueto, A. M., Vaughn-Coaxum, R.,. . .Fordwood, S. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice. American Psychologist, 72, 79-117.

79.

Wittchen, H. U., Gloster, A. T., Beesdo-Baum, K., Fava, G. A., & Craske, M. G. (2010). Agoraphobia: A review of the diagnostic classificatory position and criteria. Depression and Anxiety, 27, 113-133.

80.

World Health Organization. (2001). The world health report 2001. Mental health: New understanding, new hope. Geneva: World Health Organization.

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