Effectiveness of Mindfulness-Based Cognitive Therapy for Positive Clinical Outcome in Panic Disorder: a 5-year Longitudinal Study

Mindfulness-based cognitive therapy (MBCT) as an adjunctive to pharmacotherapy (PT) has been suggested as a good treatment option for panic disorder (PD). However, its long-term effectiveness in generating positive treatment outcomes remains to be established. We assessed the long lasting effectiveness of adjunctive MBCT up to 5 years and the influence of genetic variations on treatment outcomes in patients with PD. A total of 109 participants who received adjunctive MBCT to PT (MBCT + PT) and 109 age- and sex-matched patient controls (PT-alone) were followed up for relapse or aggravation of PD up to 5 years. The serotonin transporter gene-linked polymorphic region (5-HTTLPR), catechol-O-methyltransferase, and brain-derived neurotrophic factor polymorphisms were analyzed at baseline. Adjunctive MBCT significantly reduced the risk for relapse or aggravation of PD for up to 5 years. 5-HTTLPR polymorphism also had a significant positive effect on the long term outcome of PD; however, there was no therapygenetic effect on the benefits of adjunctive MBCT. This 5-year follow-up study demonstrated the enduring therapeutic effects of MBCT adjunctive to PD for improving long-term treatment outcome in patients with PD. Furthermore, 5-HTTLPR polymorphism may be a moderator of treatment experiences that further boost treatment success. Future investigations are warranted to establish the clinical application of MBCT and the need for personalized treatment strategies to maintain positive outcomes in patients with PD.