Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation
Efficacy of CBT for benzodiazepine discontinuation in patients with panic disorder: Further evaluation
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DOI：
10.1016/j.brat.2010.04.002
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发表时间：
2010-08-01
影响因子：
4.1
通讯作者：
Pollack, Mark H.
中科院分区：
文献类型：
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作者：
Otto, Michael W.;McHugh, R. Kathryn;Pollack, Mark H.
尽管苯二氮卓类药物（BZ）对治疗惊恐障碍具有急性疗效，但其与密切模拟焦虑感觉的戒断综合征相关，导致难以停止治疗，并且通常会复发。BZ停药的惊恐控制治疗（CBT）是一种基于认知行为的BZ停药治疗，针对这些感觉的恐惧，并已证明在预防惊恐障碍患者的疾病复发和促进成功的BZ停药方面有效。在这项随机对照试验中，将CBT与单独的锥度和锥度加放松条件进行比较，以控制47名寻求BZ锥度的惊恐障碍患者的治疗师接触和支持的效果。基于成功停用BZ的主要结局，结果表明，连续性CBT提供的附加获益高于单独的逐渐减量和逐渐减量加放松，随着时间的推移，中等和大的效应量始终在6个月随访评价时达到显著性。CBT相对于任何其他锥度条件的有效性反映了当时非常大且显著的效应量。这些研究结果表明，CBT提供了特定的疗效，成功地从BZ的中断，即使在控制治疗师的接触和放松训练。(C)2010爱思唯尔有限公司保留所有权利。
Despite its acute efficacy for the treatment of panic disorder, benzodiazepines (BZs) are associated with a withdrawal syndrome that closely mimics anxiety sensations, leading to difficulty with treatment discontinuation and often disorder relapse. An exposure-based cognitive-behavioral treatment for BZ discontinuation, Panic Control Treatment for BZ Discontinuation (CBT) targets the fear of these sensations and has demonstrated efficacy in preventing disorder relapse and facilitating successful BZ discontinuation among patients with panic disorder. In this randomized controlled trial, CBT was compared to taper alone and a taper plus a relaxation condition to control for the effect of therapist contact and support among 47 patients with panic disorder seeking taper from BZs. Based on the primary outcome of successful discontinuation of BZ use, results indicate that adjunctive CBT provided additive benefits above both taper alone and taper plus relaxation, with consistently medium and large effect sizes over time that reached significance at the six month follow-up evaluation. The efficacy of CBT relative to either of the other taper conditions reflected very large and significant effect sizes at that time. These findings suggest that CBT provides specific efficacy for the successful discontinuation from BZs, even when controlling for therapist contact and relaxation training. (C) 2010 Elsevier Ltd. All rights reserved.