Cognitive behavioral therapy for panic disorder and comorbidity: More of the same or less of more?
Cognitive behavioral therapy for panic disorder and comorbidity: More of the same or less of more?
复制标题
DOI：
10.1016/j.brat.2006.09.006
复制
发表时间：
2007-06-01
影响因子：
4.1
通讯作者：
Rose, Raphael
中科院分区：
文献类型：
--
作者：
Craske, Michelle G.;Farchione, Todd J.;Rose, Raphael
本研究比较了更高剂量的认知行为疗法（CBT）对惊恐障碍与CBT对惊恐障碍合并“偏离”的CBT对合并症的影响，这些患者的主要诊断为惊恐障碍伴或不伴广场恐怖症。65名参与者被随机分配到两种治疗条件中的一种，要么CBT只关注惊恐障碍和广场恐怖症，要么CBT同时解决惊恐障碍和广场恐怖症，并在较小程度上解决最严重的共病状况。结果表明，在两种治疗条件下，惊恐障碍的严重程度显着降低，共病诊断的严重程度下降。然而，接受CBT的个体只关注惊恐障碍，更有可能在治疗后达到高终末状态功能，即使在意向治疗分析中，并在1年随访时报告零惊恐发作，尽管这种效果在意向治疗分析中没有保留。在随访时，仅关注惊恐障碍的CBT在最严重的基线共病状况中产生了更大的改善，尽管在意向治疗分析中没有，并且即使在意向治疗分析中，这种治疗状况中的更大比例的个体也被评为没有共病诊断。这些发现提出了这样一种可能性，即继续专注于CBT治疗惊恐障碍可能比将CBT治疗惊恐障碍与“偏离”CBT治疗共病疾病相结合更有益于主要和共病诊断。爱思唯尔有限公司出版
This study compared the effects of a higher dose of cognitive behavioral therapy (CBT) for panic disorder versus CBT for panic disorder combined with "straying" to CBT for comorbid disorders in individuals with a principal diagnosis of panic disorder with or without agoraphobia. Sixty-five participants were randomly assigned to one of two treatment conditions, either CBT focused solely upon panic disorder and agoraphobia or CBT that simultaneously addressed panic disorder and agoraphobia and, to a lesser degree, the most severe comorbid condition. Results indicated a significant reduction in panic disorder severity and a decline in severity of comorbid diagnoses across both treatment conditions. However, individuals receiving CBT focused only on panic disorder were more likely to meet high end-state functioning at post-treatment, even in intent-to-treat analyses, and report zero panic attacks at the 1-year follow-up, although this effect was not retained in intent-to-treat analyses. At follow-up, CBT focused only on panic disorder yielded more substantial improvement in the most severe baseline comorbid condition, although not in intent-to-treat analyses, and a greater proportion of individuals in this treatment condition were rated as having no comorbid diagnoses, even in intent-to-treat analyses. These findings raise the possibility that remaining focused on CBT for panic disorder may be more beneficial for both principal and comorbid diagnoses than combining CBT for panic disorder with 'straying' to CBT for comorbid disorders. Published by Elsevier Ltd.