Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia

F. J. van Apeldoorn; W. J. P. J. van Hout; P. P. A. Mersch M. Huisman; B. R. Slaap; W. W. Hale; S. Visser; R. van Dyck; J. A. den Boer

doi:10.1111/j.1600-0447.2008.01157.x

Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia

F. J. van Apeldoorn^*
, W. J. P. J. van Hout
, P. P. A. Mersch M. Huisman
, B. R. Slaap
, W. W. Hale
, S. Visser
, R. van Dyck
, J. A. den Boer

^*Corresponding author for this work

University of Groningen
Utrecht University
NV Organon
University of Amsterdam

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.

Method: Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.

Results: CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI.

Conclusion: Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.

Original language	English
Pages (from-to)	260-270
Number of pages	11
Journal	Acta Psychiatrica Scandinavica
Volume	117
Issue number	4
DOIs	https://doi.org/10.1111/j.1600-0447.2008.01157.x https://doi.org/10.1111/j.1600-0447.2008.01157.x
Publication status	Published - 2008

Keywords

panic disorder
agoraphobia
randomized controlled trials
cognitive-behavioral therapy
drug treatment
COGNITIVE-BEHAVIORAL THERAPY
ANXIETY DISORDERS
EXPOSURE
PLACEBO
IMIPRAMINE
CLOMIPRAMINE
FLUVOXAMINE
PHARMACOTHERAPY
COMBINATION
DEPRESSION

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van Apeldoorn, F. J., van Hout, W. J. P. J., Huisman, P. P. A. M. M., Slaap, B. R., Hale, W. W., Visser, S., van Dyck, R., & den Boer, J. A. (2008). Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia. Acta Psychiatrica Scandinavica, 117(4), 260-270. https://doi.org/10.1111/j.1600-0447.2008.01157.x, https://doi.org/10.1111/j.1600-0447.2008.01157.x

@article{8f152e5e0f19466ca4e161d4a90613bb,

title = "Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia",

abstract = "Objective: To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.Method: Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.Results: CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI.Conclusion: Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.",

keywords = "panic disorder, agoraphobia, randomized controlled trials, cognitive-behavioral therapy, drug treatment, COGNITIVE-BEHAVIORAL THERAPY, ANXIETY DISORDERS, EXPOSURE, PLACEBO, IMIPRAMINE, CLOMIPRAMINE, FLUVOXAMINE, PHARMACOTHERAPY, COMBINATION, DEPRESSION",

author = "\{van Apeldoorn\}, \{F. J.\} and \{van Hout\}, \{W. J. P. J.\} and Huisman, \{P. P. A. Mersch M.\} and Slaap, \{B. R.\} and Hale, \{W. W.\} and S. Visser and \{van Dyck\}, R. and \{den Boer\}, \{J. A.\}",

year = "2008",

doi = "10.1111/j.1600-0447.2008.01157.x",

language = "English",

volume = "117",

pages = "260--270",

journal = "Acta Psychiatrica Scandinavica",

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van Apeldoorn, FJ, van Hout, WJPJ, Huisman, PPAMM, Slaap, BR, Hale, WW, Visser, S, van Dyck, R & den Boer, JA 2008, 'Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia', Acta Psychiatrica Scandinavica, vol. 117, no. 4, pp. 260-270. https://doi.org/10.1111/j.1600-0447.2008.01157.x, https://doi.org/10.1111/j.1600-0447.2008.01157.x

Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia. / van Apeldoorn, F. J.; van Hout, W. J. P. J.; Huisman, P. P. A. Mersch M. et al.
In: Acta Psychiatrica Scandinavica, Vol. 117, No. 4, 2008, p. 260-270.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia

AU - van Apeldoorn, F. J.

AU - van Hout, W. J. P. J.

AU - Huisman, P. P. A. Mersch M.

AU - Slaap, B. R.

AU - Hale, W. W.

AU - Visser, S.

AU - van Dyck, R.

AU - den Boer, J. A.

PY - 2008

Y1 - 2008

N2 - Objective: To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.Method: Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.Results: CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI.Conclusion: Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.

AB - Objective: To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.Method: Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.Results: CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI.Conclusion: Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.

KW - panic disorder

KW - agoraphobia

KW - randomized controlled trials

KW - cognitive-behavioral therapy

KW - drug treatment

KW - COGNITIVE-BEHAVIORAL THERAPY

KW - ANXIETY DISORDERS

KW - EXPOSURE

KW - PLACEBO

KW - IMIPRAMINE

KW - CLOMIPRAMINE

KW - FLUVOXAMINE

KW - PHARMACOTHERAPY

KW - COMBINATION

KW - DEPRESSION

U2 - 10.1111/j.1600-0447.2008.01157.x

DO - 10.1111/j.1600-0447.2008.01157.x

M3 - Article

SN - 0001-690X

VL - 117

SP - 260

EP - 270

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

IS - 4

ER -

Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia

Abstract

Keywords

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