Efficacy of 2 interventions for panic disorder in patients presenting to the ED with chest pain - 10/11/11
Abstract |
Background |
Brief and efficacious interventions for panic disorder (PD) in patients presenting to emergency departments (EDs) for chest pain are essential. This study assessed the effects of 2 interventions for this population: a brief cognitive-behavioral therapy delivered by psychologists, and a 6-month pharmacologic treatment initiated and managed by the ED physician. The relative efficacy of both interventions was also examined.
Materials and Methods |
Forty-seven adult patients meeting the diagnostic criteria for PD upon presentation to the ED were assigned to 1 of 3 experimental conditions: a brief cognitive-behavioral therapy (7 sessions), a pharmacologic intervention (paroxetine; 6 months); and a usual care control condition. The primary outcome was severity of PD on Anxiety Disorder Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and secondary outcomes included measures of PD symptoms, depressive symptoms, and cardiac anxiety. Outcome measures were taken at baseline, postintervention, as well as at 3- and 6-month follow-ups.
Results |
Patients receiving either intervention demonstrated significant reductions of PD severity (P = .012), frequency of panic attacks (P = .048), and depressive symptoms (P = .027).
Conclusion |
Taken together, these findings suggest that empirically validated interventions for PD initiated in an ED setting can be feasible and efficacious, and future studies should assess their impact on both the direct (ie, health care utilization) and indirect (ie, lost productivity) costs associated with PD morbidity in this population.
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☆ | Sources of support: This research was funded by a grant to the second author from the Canadian Institutes of Health Research (153245), as well as scholarships to the first author from the Hopital du Sacré-Cœur de Montréal Research Center and the Fonds de Recherche en Santé du Québec (no. 12565). |
Vol 29 - N° 9
P. 1051-1061 - novembre 2011 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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