Search

Patients with panic disorder with agoraphobia (PDA) or generalized anxiety disorder (GAD) frequently also suffer from insomnia. However, the impact of cognitive-behavioral therapy (CBT) for anxiety disorders on insomnia has been understudied. Furthermore, comorbidity between anxiety disorders is common. Our main objective was to assess the impact of CBT for PDA or GAD on insomnia. In a quasi-experimental design, 86 participants with PDA and GAD received conventional CBT for their primary disorder or combined CBT for both disorders. Overall, CBTs had a significant impact on reducing insomnia symptoms (η = 0.58). However, among people with insomnia at pretest (67%), 33% still had an insomnia diagnosis, and the majority (63%) had clinically significant residual insomnia following treatment. In conclusion, the CBTs had a positive effect on the reduction of insomnia, but a significant proportion of participants still had insomnia problems following treatment. Clinicians should address insomnia during CBT for PDA and GAD.

Concurrent panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) are the most common diagnostic occurrences among anxiety disorders. This particular comorbidity is associated with significant impairments in quality of life (QOL). The current study sought to investigate the efficacy of a combined cognitive-behavioral psychotherapy that addressed both conditions compared with a conventional psychotherapy, which attends solely to the primary disorder. The hypotheses postulated firstly, that both treatment conditions would lead to improvements in participants' QOL and secondly, that the combined therapy would lead to greater QOL ameliorations. Twenty-five participants with comorbid PDA/GAD diagnoses were evaluated with a number of clinical interviews and self-report questionnaires, and were provided with either conventional or combined cognitive-behavioral psychotherapy, which consisted of 14 one-hour weekly sessions. Participants were once again evaluated in the same fashion 2-weeks after the completion of the psychotherapy. The results revealed that both conditions led to significant improvements in participants' QOL, but that the two groups did not significantly differ in terms of the effect on QOL. The results also reveal that the two conditions did not significantly differ in terms of their effect on PDA and GAD symptomatology or psychiatric comorbidity. The results demonstrate that the combined psychotherapy, which addresses both conditions simultaneously, is similar to the conventional psychotherapy employed for the primary disorder in terms of QOL enhancement, symptom severity, and comorbidity reduction.

The aim of this research was to examine the efficacy of two cognitive-behavioral treatment modalities for panic disorder (PD) with nocturnal panic (NP). The first study was conducted to determine whether conventional CBT for PD was effective for PD with NP in three participants. A second study sought to explore whether a CBT adapted to NP would lead to different clinical outcomes in three other participants. A multiple-baseline single-case design across individuals was used in both studies. Treatment outcome was assessed with standardized clinician ratings, self-report questionnaires, and daily self-monitoring. Results revealed that both the conventional and the adapted treatments showed a faster decrease in NPs versus daytime panics and significant clinical changes in all measures for up to a year after therapy. Hence, the changes brought about by the adapted treatment seemed to be similar to those obtained using conventional treatment. In light of these results, it can be presumed that conventional strategies may be sufficient for the treatment of NP. These observations raise questions regarding the real need to adapt treatments specifically to NP.

The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary GAD took part in the study. The efficacy of the treatment was assessed by means of a structured interview, self-administered questionnaires, and daily self-monitoring measures. After treatment, 2 of the 3 participants achieved high end-state functioning and maintained this level of functioning at 3-, 6-, and 12-month follow-ups. The third participant also improved but only reached high end-state functioning at 6-month follow-up. It therefore appears that the combined treatment is relatively effective for PDA-GAD comorbidity. Possible avenues for improving the treatment are suggested.

The goal of this study was to evaluate the efficacy of a cognitive-behavioral treatment package for comorbid generalized anxiety disorder (GAD) and panic disorder with agoraphobia (PDA). A single-case, multiple-baseline, across-subjects design was used with 3 primary GAD patients with secondary PDA. The efficacy of the treatment was evaluated with a structured interview, a battery of self-report questionnaires, and daily self-monitoring booklets. Results are promising: At posttreatment, 2 out of 3 participants achieved high endstate functioning and maintained this level at 3-, 6-, and 12-month follow-ups. The 3rd participant also improved but achieved moderate endstate functioning. The strengths and limitations of the treatment are discussed.