联合疗法是否比单独使用认知行为疗法（CBT）或选择性5-羟色胺再摄取抑制剂（SSRI）更有效？一项关于伴或不伴广场恐惧症的惊恐障碍的多中心试验结果。
Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia.
作者信息
van Apeldoorn F J, van Hout W J P J, Mersch P P A, Huisman M, Slaap B R, Hale W W, Visser S, van Dyck R, den Boer J A
机构信息
University Medical Center Groningen, Groningen, The Netherlands.
出版信息
Acta Psychiatr Scand. 2008 Apr;117(4):260-70. doi: 10.1111/j.1600-0447.2008.01157.x. Epub 2008 Feb 26.
OBJECTIVE
To establish whether the combination of cognitive-behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono-treatments.
METHOD
Patients with PD (n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper.
RESULTS
CBT + SSRI was clearly superior to CBT in both completer and intent-to-treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI.
CONCLUSION
Both the mono-treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post-test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.
目的
确定认知行为疗法（CBT）与药物疗法（SSRI）联合使用在治疗惊恐障碍（PD）方面是否比单独使用CBT或SSRI更有效，并评估单一疗法之间的任何差异效应。
方法
有或无广场恐惧症的惊恐障碍患者（n = 150）接受CBT、SSRI或CBT + SSRI治疗。在9个月后、药物逐渐减量前评估结果。
结果
在完成者分析和意向性治疗分析（ITT）中，CBT + SSRI均明显优于CBT。完成者分析显示，在三项指标上CBT + SSRI优于SSRI，而CBT和SSRI之间无差异。ITT分析显示，在四项指标上SSRI优于CBT，而CBT + SSRI和SSRI之间无差异。
结论
单一疗法（CBT和SSRI）及联合疗法（CBT + SSRI）均被证明是治疗惊恐障碍的有效方法。在测试后，CBT + SSRI明显优于CBT，但CBT + SSRI与SSRI之间以及SSRI与CBT之间的差异较小。
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