Cognitive therapy of panic disorder: a nonpharmacological alternative

Article Abstract:

Panic disorder is a psychiatric illness characterized by panic attacks, or sudden, severe episodes of anxiety or fright. While some experts favor drug therapy for panic disorder, others prefer nonpharmacological approaches, such as cognitive therapy. Some of the drawbacks of using medication are side effects, difficulty with withdrawal from the medication, and possible return of panic symptoms after stopping the drug. In this study, the effectiveness of cognitive therapy was evaluated in 17 adults with panic disorder. The patients had experienced panic attacks for an average of 2.4 years (range of 1 month to 7 years), and the attacks were more often spontaneous than situational (triggered by a particular situation). During an average of 18 individual cognitive therapy sessions, patients were encouraged to experience their panic symptoms (such as hyperventilation). The patients then learned to interpret the sensations as less unpleasant and threatening than they had previously perceived them to be. They also learned to control their symptoms through breathing exercises and positive self-statements, and practiced these techniques in real-life situations that they had previously feared and avoided. The patients maintained logs of their panic attacks, and by the end of treatment all 17 patients had stopped having attacks, representing a significant reduction in the incidence of episodes. In addition, the patients' reports of general anxiety and depression were reduced. These beneficial effects continued at follow-up one year later. The results of this study provide preliminary evidence that cognitive therapy is an effective alternative to drug therapy for panic disorder. Patients who have experienced medication side effects or have increased risk for becoming dependent on drugs may be particularly good candidates for the cognitive approach. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Relationship between hopelessness and ultimate suicide: a replication with psychiatric outpatients

Article Abstract:

For the last few decades, researchers have been trying to find a sensitive indicator to identify those at high risk for suicide. One of the psychological variables that has been strongly associated with suicidal behavior, and one that has been thought to be a predictive factor, is hopelessness. A large outpatient population was evaluated between September 1978 and February 1985. All 1,958 patients were measured on the Beck Hopelessness Scale and the Beck Depression Inventory. When the patients were rated, a score of nine or more identified 16 of the 17 individuals who ultimately committed suicide. This confirmed previous studies that had identified hopelessness as a strong correlating factor for increased risk for suicide. It was concluded that the Beck Hopelessness Scale is a useful instrument in suicide risk prediction. Over 94 percent of the victims were positively identified by this test. Patients scoring over nine points on the scale were 11 times more likely to commit suicide than the other outpatients. The measure of hopelessness is a useful tool because it cuts across demographic categories such as sex, age, and socioeconomic status, and it can be used to assess the suicide potential of individuals within other known risk groups. The identification of hopelessness is also significant because prior research has indicated that this symptom can be successfully treated. Cognitive therapy, in particular, has resulted in rapid reduction of hopelessness scores. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Prevention, Suicide, Suicide prevention, Hope

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Cognitive-behavioral therapy for panic: an open study

Article Abstract:

Patients who suffer from panic disorders may benefit from treatment with a variety of psychoactive drugs. Imipramine has been established as a useful treatment, and other drugs appear to be beneficial as well. However, some patients do not want to take drugs and there is some indication that panic patients may be particularly susceptible to adverse side effects. A study was undertaken to evaluate the efficacy of cognitive and behavioral therapy methods in 26 patients with panic disorder or with agoraphobia and panic attacks. Treatment consisted of weekly individual sessions scheduled for 24 weeks or until the patient was free of significant symptoms for at least a month. The therapy sessions resulted in significant improvements in symptoms, as well in avoidance behaviors. A general reduction in anxiety level was also found. These results indicate that cognitive-behavioral therapy can provide an effective therapeutic alternative to drug therapy for panic patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Behavior therapy

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• Abstracts: Cognitive-behavior therapy for panic disorder delivered by psychopharmacologically oriented clinicians. Treatment of body-dysmorphic disorder with serotonin reuptake blockers

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