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The efficacy of two forms of psychotherapy with panic disordered patients, a cognitive-behavioral and a psychodynamic one, are compared under two different, randomized conditions: randomization or self-selection. The basic hypotheses are that the efficacy of both treatments is higher and that the efficacy difference is smaller under self-selection than randomized conditions.
After thorough assessment persons with a panic disorder diagnosis are randomly assigned to three arms: one randomization, one self-selection, and one a low-contact waiting list one. In the randomization arm (R) 95 persons are randomly assigned to Panic Control Treatment (PCT) or Panic-Focused Psychodynamic Psychotherapy (PFPP); in the self-selection arm (SS) 95 persons are offered, after adequate information, to choose which of the two they prefer. Twenty-six persons are initially randomized to a three-month waiting list (with sparse contact over telephone), after which they will be re-randomized, either to further randomization (to PCT or PFPP) or to self-selection. The four groups (R/PCT; R/PFPP; SS/PCT; SS/PFPP) will be compared on the basis of intake and repeated outcome/follow-up assessment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Randomized Panic Control Treatment | Experimental | Patients who have been randomized to the randomization condition are assigned to PCT |
|
| Randomized Panic-Focused Psychodynamic Psychotherapy | Experimental | Patients who have been randomized to the randomization condition are assigned to PFPP |
|
| Self-selected Panic Control Treatment | Experimental | Patients who have been randomized to the self-selection condition choose PCT |
|
| Self-selected Panic-Focussed Psychodynamic Psychotherapy | Experimental | Patients who have been randomized to the self-selection condition choose PFPP |
|
| Waiting-list | Experimental | Patients who have been randomized to the waiting-list are offered sparse contact over telephone for 12 weeks and are then re-randomized to one of the other four arms |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Panic Control Treatment (PCT) | Behavioral | Manualized, 13 sessions (60 min, sometimes extended to 90-120) completed in 12-16 weeks. Total duration 840-1080 min. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change on Panic Disorder Severity Scale (PDSS; Shear et al., 1997) | Growth curve analysis across intake and follow up at termination and 6, 12 and 24 months after termination | |
| Change in occupational status | Growth curve analysis across intake and follow up at termination and 6, 12 and 24 months after termination | |
| Change in absence from work due to sickness | Growth curve analysis across 3 months before intake, intake and follow up at termination and 6, 12 and 24 months after termination |
| Measure | Description | Time Frame |
|---|---|---|
| Change on Mobility Inventory for Agoraphobia (MI, Chambless et al, 1985) | Growth curve analysis across intake and follow up at termination and 6, 12 and 24 months after termination | |
| Change in health care utilization (number of medical contacts, and emergency visits, medication) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rolf Sandell, PhD | Lund University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lund University | Lund | SE-221 00 | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34591549 | Derived | Nilsson T, Falkenstrom F, Perrin S, Svensson M, Johansson H, Sandell R. Exploring termination setback in a psychodynamic therapy for panic disorder. J Consult Clin Psychol. 2021 Sep;89(9):762-772. doi: 10.1037/ccp0000678. | |
| 33148129 | Derived | Svensson M, Nilsson T, Perrin S, Johansson H, Viborg G, Sandell R. Preferences for panic control treatment and panic focused psychodynamic psychotherapy for panic disorder - who chooses which and why? Psychother Res. 2021 Jun;31(5):644-655. doi: 10.1080/10503307.2020.1839686. Epub 2020 Nov 5. |
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| ID | Term |
|---|---|
| D016584 | Panic Disorder |
| ID | Term |
|---|---|
| D001008 | Anxiety Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D014850 | Waiting Lists |
| ID | Term |
|---|---|
| D001071 | Appointments and Schedules |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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| Panic-Focused Psychodynamic Psychotherapy (PFPP) | Behavioral | Manualized, 19-24 sessions (45 min) completed in 12-16 weeks. Total duration 855-1080 min. |
|
| Waiting-list | Other | Sparse telephone contact during 12 weeks, then re-randomization |
|
| Growth curve analysis across 3 months before intake, intake and follow up at termination and 6, 12 and 24 months after termination |
| Change on Clinical Outcomes in Routine Evaluation Scale(CORE; Evans et al., 2000) | Growth curve analysis across intake and follow up at termination and 6, 12 and 24 months after termination |
| Change on Montgomery Asberg Depression Rating Scale (MADRS-S; Montgomery & Asberg, 1979) | Growth curve analysis across intake and follow up at termination and 6, 12 and 24 months after termination |
| 30636466 | Derived | Svensson M, Nilsson T, Johansson H, Viborg G, Perrin S, Sandell R. Psychometric analysis of the Swedish panic disorder severity scale and its self-report version. Nord J Psychiatry. 2019 Jan;73(1):58-63. doi: 10.1080/08039488.2018.1554699. Epub 2019 Jan 14. |
| 25873067 | Derived | Sandell R, Svensson M, Nilsson T, Johansson H, Viborg G, Perrin S. The POSE study - panic control treatment versus panic-focused psychodynamic psychotherapy under randomized and self-selection conditions: study protocol for a randomized controlled trial. Trials. 2015 Mar 31;16:130. doi: 10.1186/s13063-015-0656-7. |