Psychotherapy and Psychosomatics

Regular Article

Treating Medication-Resistant Panic Disorder: Predictors and Outcome of Cognitive-Behavior Therapy in a Brazilian Public Hospital

Heldt E.a · Manfro G.G.a · Kipper L.a · Blaya C.a · Maltz S.a · Isolan L.a · Hirakata V.N.a · Otto M.W.b

Author affiliations

aAnxiety Disorder Program, Hospital de Clínicas de Porto Alegre, RS and Postgraduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; bCognitive-Behavior Therapy Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Mass., USA

Keywords: Panic disorderCognitive behavior therapyDepressionDefense mechanismsComorbidity

Related Articles for ""
Psychother Psychosom 2003;72:43–48
https://doi.org/10.1159/000067188

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: December 16, 2002
Issue release date: January – February

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 4

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

Abstract

Background: In Brazil, treatment of panic disorder is most frequently initiated with pharmacotherapy, but only half of the patients can be expected to be panic free after medication. Studies have suggested that individual or group cognitive-behavior therapy (CBT) is an effective treatment strategy for panic patients who have failed to respond to pharmacotherapy. Methods: Thirty-two patients diagnosed with panic disorder with agoraphobia having residual symptoms despite being on an adequate dose of medication were treated with 12 weeks of group CBT. The outcome was evaluated for panic frequency and severity, generalized anxiety, and global severity. Comorbid conditions, a childhood history of anxiety, and defense mechanism styles were assessed as potential predictors of treatment response. Results: Twenty-nine patients completed the 12-week protocol. Treatment was associated with significant reductions in symptom severity on all outcome measures (p < 0.001). Patients with depression had a poorer outcome of the treatment (p = 0.01) as did patients using more neurotic (p = 0.002) and immature defenses (p = 0.05). Conclusion: Consistent with previous reports, we found that CBT was effective for our sample of treatment-resistant patients. Among these patients, depression as well as neurotic defense style was associated with a poorer outcome. The use of CBT in Brazil for treatment-resistant and other panic patients is encouraged.

© 2003 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Published online: December 16, 2002
Issue release date: January – February

Number of Print Pages: 6
Number of Figures: 0
Number of Tables: 4

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: https://www.karger.com/PPS

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2003, Vol.72, No. 1

January – February

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The authors of this paper have no conflicts of interest relevant to the information presented here.
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