Facing the fear--clinical and neural effects of cognitive behavioural and pharmacotherapy in panic disorder with agoraphobia

European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology
Carolin LiebscherAndreas Ströhle

Abstract

Cognitive behavioural therapy (CBT) and pharmacological treatment with selective serotonin or serotonin-noradrenalin reuptake inhibitors (SSRI/SSNRI) are regarded as efficacious treatments for panic disorder with agoraphobia (PD/AG). However, little is known about treatment-specific effects on symptoms and neurofunctional correlates. We used a comparative design with PD/AG patients receiving either two types of CBT (therapist-guided (n=29) or non-guided exposure (n=22)) or pharmacological treatment (SSRI/SSNRI; n=28) as well as a wait-list control group (WL; n=15) to investigate differential treatment effects in general aspects of fear and depression (Hamilton Anxiety Rating Scale HAM-A and Beck Depression Inventory BDI), disorder-specific symptoms (Mobility Inventory MI, Panic and Agoraphobia Scale subscale panic attacks PAS-panic, Anxiety Sensitivity Index ASI, rating of agoraphobic stimuli) and neurofunctional substrates during symptom provocation (Westphal-Paradigm) using functional magnetic resonance imaging (fMRI). Comparisons of neural activation patterns also included healthy controls (n=29). Both treatments led to a significantly greater reduction in panic attacks, depression and general anxiety than the WL group. The ...Continue Reading

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Citations

Apr 13, 2017·World Journal of Psychiatry·Thomas Sobanski, Gerd Wagner
Dec 17, 2019·The American Journal of Psychiatry·Yunbo YangTilo Kircher
Oct 6, 2018·European Archives of Psychiatry and Clinical Neuroscience·Susanne NeufangKatharina Domschke

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