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Capstone

The Efficacy and Feasibility of Cognitive-Behavioral Therapy for the Treatment of Patients With Panic Disorder in Primary Care

1 August 2007

Abstract

Background: Panic Disorder (PD) is a relatively common ailment in the United States, and health care utilization among patients with PD is disproportionately high. Cognitive Behavioral Therapy (CBT) is a unique form of psychotherapy based on the assumption that how we think, feel, and act are intrinsically related. In CBT, the provider and patient collaborate in a highly-structured time-limited environment in order to empower patients to tackle their problems with their own resources.

Study Design: Literature Review

Methods: The literature was searched using the following terms, both separately and combined: cognitive behavioral therapy, cognitive behavior therapy, panic, and panic disorder. The databases searched were Ovid, PsychINFO, and the Cochrane Central Register of Controlled Trials. The search was limited by the following criteria: full text availability, English language, publication dates 1985-2007, and free of charge. After relevant articles were chosen, the references of those articles were reviewed and more specific articles were sought and retrieved: Finally, three randomized-controlled trials, one meta-analysis, and one Cochrane Systematic Review were chosen to be evaluated.

Results: CBT is at least as effective as, and perhaps more durable than, pharmacotherapy alone and combination therapy (pharmacotherapy plus CBT) for PD.

Conclusion: CBT is an effective first- and second-line treatment for panic disorder, and PCPs can provide effective CBT with minimal training. While CBT is clinically feasible in the primary care setting, it is time consuming both for the patient and the provider, requires training not usually included in formal medical education, may not be available to rural, underserved or low-income populations, and may be outside the typical scope of practice of a PCP.


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