Article2007

A Randomized Controlled Clinical Trial of Psychoanalytic Psychotherapy for Panic Disorder

Barbara L Milrod · Andrew C. Leon · Fredric N. Busch · Marie G. Rudden · Michael D. Schwalberg · John C. Clarkin +7 more

323 citations0/0 files storedAmerican Journal of Psychiatry

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Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Psychoanalysis and Psychopathology Research Psychotherapy Techniques and Applications

Abstract

OBJECTIVE: The purpose of this study was to determine the efficacy of panic-focused psychodynamic psychotherapy relative to applied relaxation training, a credible psychotherapy comparison condition. Despite the widespread clinical use of psychodynamic psychotherapies, randomized controlled clinical trials evaluating such psychotherapies for axis I disorders have lagged. To the authors' knowledge, this is the first efficacy randomized controlled clinical trial of panic-focused psychodynamic psychotherapy, a manualized psychoanalytical psychotherapy for patients with DSM-IV panic disorder. METHOD: This was a randomized controlled clinical trial of subjects with primary DSM-IV panic disorder. Participants were recruited over 5 years in the New York City metropolitan area. Subjects were 49 adults ages 18-55 with primary DSM-IV panic disorder. All subjects received assigned treatment, panic-focused psychodynamic psychotherapy or applied relaxation training in twice-weekly sessions for 12 weeks. The Panic Disorder Severity Scale, rated by blinded independent evaluators, was the primary outcome measure. RESULTS: Subjects in panic-focused psychodynamic psychotherapy had significantly greater reduction in severity of panic symptoms. Furthermore, those receiving panic-focused psychodynamic psychotherapy were significantly more likely to respond at treatment termination (73% versus 39%), using the Multicenter Panic Disorder Study response criteria. The secondary outcome, change in psychosocial functioning, mirrored these results. CONCLUSIONS: Despite the small cohort size of this trial, it has demonstrated preliminary efficacy of panic-focused psychodynamic psychotherapy for panic disorder.

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References

1960A RATING SCALE FOR DEPRESSION 1959THE ASSESSMENT OF ANXIETY STATES BY RATING 1997Multicenter Collaborative Panic Disorder Severity Scale 2000Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder 1994A Comparison of Cognitive Therapy, Applied Relaxation and Imipramine in the Treatment of Panic Disorder 1993Alprazolam and Exposure Alone and Combined in Panic Disorder with Agoraphobia 1989Quality of Life in Panic Disorder

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