Department of Clinical Psychological Science, Faculty of Neuroscience and Psychology, Maastricht University, The Netherlands.
Psychol Med. 2012 Dec;42(12):2661-72. doi: 10.1017/S0033291712000876. Epub 2012 Apr 30.
Interpersonal psychotherapy (IPT) seems to be as effective as cognitive behavioral therapy (CBT) in the treatment of major depression. Because the onset of panic attacks is often related to increased interpersonal life stress, IPT has the potential to also treat panic disorder. To date, a preliminary open trial yielded promising results but there have been no randomized controlled trials directly comparing CBT and IPT for panic disorder.
This study aimed to directly compare the effects of CBT versus IPT for the treatment of panic disorder with agoraphobia. Ninety-one adult patients with a primary diagnosis of DSM-III or DSM-IV panic disorder with agoraphobia were randomized. Primary outcomes were panic attack frequency and an idiosyncratic behavioral test. Secondary outcomes were panic and agoraphobia severity, panic-related cognitions, interpersonal functioning and general psychopathology. Measures were taken at 0, 3 and 4 months (baseline, end of treatment and follow-up).
Intention-to-treat (ITT) analyses on the primary outcomes indicated superior effects for CBT in treating panic disorder with agoraphobia. Per-protocol analyses emphasized the differences between treatments and yielded larger effect sizes. Reductions in the secondary outcomes were equal for both treatments, except for agoraphobic complaints and behavior and the credibility ratings of negative interpretations of bodily sensations, all of which decreased more in CBT.
CBT is the preferred treatment for panic disorder with agoraphobia compared to IPT. Mechanisms of change should be investigated further, along with long-term outcomes.
人际心理治疗（IPT）在治疗重度抑郁症方面似乎与认知行为疗法（CBT）同样有效。由于惊恐发作的发作常常与人际生活压力增加有关，IPT 有可能也可以治疗惊恐障碍。迄今为止，一项初步的开放试验结果令人鼓舞，但还没有直接比较 CBT 和 IPT 治疗惊恐障碍的随机对照试验。
本研究旨在直接比较 CBT 与 IPT 治疗伴有广场恐怖症的惊恐障碍的效果。91 名成人患者被诊断为 DSM-III 或 DSM-IV 惊恐障碍伴广场恐怖症，被随机分组。主要结局是惊恐发作频率和特定的行为测试。次要结局为惊恐和广场恐怖症严重程度、惊恐相关认知、人际关系功能和一般精神病理学。在 0、3 和 4 个月（基线、治疗结束和随访）时进行测量。
意向治疗（ITT）分析主要结局表明 CBT 治疗伴有广场恐怖症的惊恐障碍效果更好。按方案分析强调了两种治疗方法之间的差异，并产生了更大的效果大小。除了广场恐怖症的抱怨和行为以及对身体感觉的负面解释的可信度评分，两种治疗方法对次要结局的改善是相等的，而这两者在 CBT 中都有更大程度的降低。
与 IPT 相比，CBT 是治疗伴有广场恐怖症的惊恐障碍的首选治疗方法。应进一步调查治疗效果的机制，以及长期结局。
