Dept. Basic Psychology and Methodology, Faculty of Psychology, University of Murcia, Spain.
Clin Psychol Rev. 2010 Feb;30(1):37-50. doi: 10.1016/j.cpr.2009.08.011.
Although the efficacy of psychological treatment for panic disorder (PD) with or without agoraphobia has been the subject of a great deal of research, the specific contribution of techniques such as exposure, cognitive therapy, relaxation training and breathing retraining has not yet been clearly established. This paper presents a meta-analysis applying random- and mixed-effects models to a total of 65 comparisons between a treated and a control group, obtained from 42 studies published between 1980 and 2006. The results showed that, after controlling for the methodological quality of the studies and the type of control group, the combination of exposure, relaxation training, and breathing retraining gives the most consistent evidence for treating PD. Other factors that improve the effectiveness of treatments are the inclusion of homework during the intervention and a follow-up program after it has finished. Furthermore, the treatment is more effective when the patients have no comorbid disorders and the shorter the time they have been suffering from the illness. Publication bias and several methodological factors were discarded as a threat against the validity of our results. Finally the implications of the results for clinical practice and for future research are discussed.
虽然心理治疗对伴有或不伴有广场恐惧症的惊恐障碍（PD）的疗效已经是大量研究的主题，但暴露、认知疗法、放松训练和呼吸训练等技术的具体贡献尚未明确确立。本文通过随机和混合效应模型对 1980 年至 2006 年期间发表的 42 项研究中总共 65 个治疗组与对照组之间的比较进行了荟萃分析。结果表明，在控制研究方法质量和对照组类型后，暴露、放松训练和呼吸训练的结合为治疗 PD 提供了最一致的证据。提高治疗效果的其他因素包括在干预过程中包含家庭作业以及干预结束后的后续计划。此外，当患者没有合并疾病且患病时间较短时，治疗效果更好。由于对结果的有效性构成威胁，因此排除了发表偏倚和几个方法学因素。最后讨论了结果对临床实践和未来研究的意义。
