Am J Psychiatry 1992; 149:778-783
Copyright © 1992 by American Psychiatric Association
A crossover study of focused cognitive therapy for panic disorder
AT Beck, L Sokol, DA Clark, R Berchick and F Wright
Center for Cognitive Therapy, University of Pennsylvania Medical School, Philadelphia.
OBJECTIVE: This study sought to determine the short- and long-term effects
of focused cognitive therapy for panic disorder. METHOD: Thirty- three
psychiatric outpatients with the DSM-III diagnosis of panic disorder were
randomly assigned to either 12 weeks of individual, focused cognitive
therapy or 8 weeks of brief supportive psychotherapy based on principles of
client-centered therapy. The patients who received supportive psychotherapy
were subsequently given the opportunity to cross over to cognitive therapy
for 12 weeks. Patients were rated for panic and depression before therapy,
after 4 and 8 weeks of therapy, and at 6-month and 1-year follow-up.
RESULTS: Clinician ratings and self-ratings of panic frequency and
intensity indicated that the focused cognitive therapy group achieved
significantly greater reductions in panic symptoms and general anxiety
after 8 weeks of treatment than did the group that received brief
supportive psychotherapy. At 8 weeks, 71% of the cognitive therapy group
were panic free, compared to 25% of the psychotherapy group. Moreover, 94%
of the psychotherapy patients elected to cross over to 12 weeks of
cognitive therapy. At 1-year follow-up, 87% of the group that received
cognitive therapy only and 79% of the group that crossed over into
cognitive therapy remained free of panic attacks. CONCLUSIONS: Focused
cognitive therapy offers a promising nonpharmacological alternative for the
treatment of panic disorder.
