Treatment Response to Panic-Focused Psychotherapy Typically Maintained Over 12 Months

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Patients who respond to panic-focused psychotherapy appear to maintain their improvements following treatment termination.
Patients who respond to panic-focused psychotherapy appear to maintain their improvements following treatment termination.

Patients with panic disorder who experienced symptomatic improvements during the active phase of treatment typically maintained improvements for a year, per study data published in the Journal of Clinical Psychiatry.

Investigators assessed the 12-month outcomes of patients with panic disorder who had undergone 1 of 3 treatments in a prior randomized controlled trial: panic-focused psychodynamic psychotherapy (n=47), cognitive-behavioral therapy (n=51), or applied relaxation training (n=18). Participants were selected for the current study if they had experienced a ≥40% reduction in panic and avoidance symptoms on the Panic Disorder Severity Scale (PDSS) following 12 to 14 weeks of their respective therapy. Patients were assessed once-monthly during follow-up on the PDSS, the Sheehan Disability Scale (SDS), and the Hamilton Depression Rating Scale (HDRS). These scores were compared with initial score changes observed at baseline and immediately post-treatment.

Of 116 responders, 78% (n=91) provided at least 1 PDSS datapoint during follow-up. Responders who provided follow-up data had significantly lower PDSS, HDRS, and SDS scores following initial treatment compared with responders who did not (all P <.03). Participants who met response criteria maintained their improvements on the PDSS, SDS, and HDRS over the 12-month follow-up period. In addition, 57% of improved patients did not have a panic disorder diagnosis by the end of 12 months, independent of initial treatment received. No differences in rates of remission were observed across treatment conditions at either 6 or 12 months. Changes in PDSS, HDRS, and SDS scores over time were also not significant across conditions. Researchers noted that patients who provided follow-up data typically had lower symptom levels after treatment compared with patients who did not provide data.  

On average, researchers observed no significant decline or further improvement in panic disorder symptomatology in the 12 months following treatment termination. Data should be extrapolated with care, however, given the higher attrition rates in patients with more severe symptoms. Still, patients who respond to panic-focused psychotherapy appear to maintain their improvements following treatment termination. In light of this information, future research should focus on maximizing initial treatment response in patients with panic disorder.

Reference

McCarthy KS, Chambless DL, Solomonov N, Milrod B, Barber JP. Twelve-month outcomes following successful panic-focused psychodynamic psychotherapy, cognitive-behavioral therapy, or applied relaxation training for panic disorder. J Clin Psychiatry. 2018;97(5):17m11807.

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