期刊
PSYCHOLOGICAL MEDICINE
卷 35, 期 11, 页码 1645-1654出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S003329170500557X
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资金
- NIMH NIH HHS [MH 64122, MH 58915, MH 57858, MH 57835, MH 065324] Funding Source: Medline
Background. Randomized clinical trials indicate a benefit from combining medications with cognitive behavioral therapy (CBT) relative to medication alone for panic disorder. Using an as-treated analysis, we evaluated whether the addition of CBT enhanced outcomes for panic disorder relative to medications alone in the primary-care setting. Method. Primary-care patients with panic disorder reported on their receipt of CBT and medications over the 3 months following baseline assessment. The degree to which outcomes for those who used anti-panic medications were enhanced by the receipt of at least one component of CBT was analyzed using a propensity score model that took into account observable baseline patient characteristics influencing both treatment selection and outcomes. Results. The addition of CBT resulted in statistically and clinically significant improvements at 3 months on anxiety sensitivity, social avoidance, and disability. Also, patients receiving CBT in the first 3 months of the Study were more improved at 12 months than patients who took medications only during the first 3 months of the study. Conclusions. The clinical utility of the findings are discussed in terms of the importance of primary-care physicians encouraging their panic disorder patients to receive CBT as well as medications.
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