Psychological treatments of panic disorder without agoraphobia: Cognitive therapy versus applied relaxation

This study compared two psychological treatments of panic disorder and tested whether cognitive therapy (CT) was superior to applied relaxation (AR); and whether treatment was superior to waiting. Thirty-six outpatients of the community mental health center with the DSM-III-R diagnosis of panic disorder with no or mild agoraphobia were randomly assigned to CT or AR. Eighteen similar patients who were referred after the treatment conditions were complete constituted a waiting-list group. Treatment consisted of 12 weekly sessions. Patients self-monitored panic attacks during the whole treatment period, and the following 4 weeks, and during 1 week at a half-year follow-up. Questionnaires were filled out before and after treatment, and at 4-week and half-year follow-ups. After the first follow-up additional treatment was provided if clinically indicated. One patient dropped out of AR and was replaced. Treatment was superior to waiting in reducing panic and questionnaire scores. CT was clearly superior to AR in reducing panic frequency, and somewhat less strongly superior to AR in reducing the questionnaire scores. Depending on the assessment point, 77.8-83.3% of the CT patients was panic-free after treatment, compared to 50% of the AR and 27.7% of the waiting-list patients. In conclusion, cognitive therapy for panic is especially effective in reducing the incidence of panic attacks.