Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy : A Randomized Controlled Switching Trial

Medientyp: E-Artikel

Titel: Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy : A Randomized Controlled Switching Trial

Beteiligte: Gloster, Andrew T. [VerfasserIn]; Sonntag, Rainer [VerfasserIn]; Hoyer, Jürgen [VerfasserIn]; Meyer, Andrea H. [VerfasserIn]; Heinze, Simone [VerfasserIn]; Ströhle, Andreas [VerfasserIn]; Eifert, Georg [VerfasserIn]; Wittchen, Hans-Ulrich [VerfasserIn]

Erschienen: Basel : Karger, [2020]

Sprache: Englisch

DOI: 10.1159/000370162

Schlagwörter: Treatment-resistant patients ; Agoraphobia ; Acceptance and commitment therapy ; Agoraphobie ; medicine ; Therapiewechsel ; Nonresponders ; Medizin ; Therapy switching ; behandlungsresistente Patienten ; Panic disorder ; Panikstörung ; Akzeptanz- und Bindungstherapie ; Non-Responder

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Anmerkungen: Hinweis: Link zum Artikel der zuerst in der Zeitschrift 'Psychotherapy and Psychosomatics' erschienen ist DOI: 10.1159/000370162

Beschreibung: Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who received ACT reported significantly more improvements on the PAS and CGI (d = 0.72 and 0.89, respectively) than those who were on the waiting list, while improvement on the MI (d = 0.50) was nearly significant. Secondary outcomes were consistent with ACT theory. Follow-up assessments indicated a stable and continued improvement after treatment. The dropout rate was low (9%). Conclusions: Despite a clinically challenging sample and brief treatment administered by novice therapists, patients who received ACT reported significantly greater changes in functioning and symptomatology than those on the waiting list, with medium-to-large effect sizes that were maintained for at least 6 months. These proof-ofprinciple data suggest that ACT is a viable treatment option for treatment-resistant PD/A patients. Further work on switching to psychotherapy for nonresponders is clearly needed.

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