Physical activity (treadmill) prior to in-vivo exposure supports the effect of cognitive behavioural therapy in patients with panic disorder and agoraphobia.

Patients receive a 12-session manualized cognitive behavioural therapy, implemented over 7 weeks and followed by two booster sessions. Five sessions consist of in-vivo exposures. Prior to these sessions patients undergo a training of physical activity. Half of the patients complete training on a treadmill at 70% of their maximal oxygen uptake while the other half complete training at 30%.

Inclusion Criteria:

• Subject familiarized with experimental procedure and had given written informed consent
• Diagnosis of panic disorder with agoraphobia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
• Score >= 18 in Hamilton Rating Scale for Anxiety
• Score >= 4 in Clinical Global Index
• Reachability of patient for treatment and follow-up

Exclusion Criteria:

• DSM-IV Axis I diagnoses of any psychotic disorder, bipolar disorder, current alcohol or drug dependence and Axis II borderline personality disorder
• Change in pharmacological treatment in the last 4 weeks
• Acute suicidality
• Medical contraindications for mild to moderate exercise training or exposure