First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece,
First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Neuropsychobiology. 2021;80(5):401-410. doi: 10.1159/000514073. Epub 2021 Mar 18.
Data regarding the potential association between the outcome of psychotherapy of panic disorder (PD) and biological parameters are few. In 21 (16 females) consecutively referred, medication-free, acutely ill PD outpatients, without comorbidities, except agoraphobia, we systematically explored for potential neuroendocrine and clinical correlates of response to a brief cognitive behavior therapy (CBT).
Cortisol and adrenocorticotropic hormone (ACTH) basal plasma levels were measured. Measures of psychopathology: (a) Symptom Checklist-90-Revised (SCL-90-R), (b) Clinical Global Impressions-Improvement (CGI-I) Scale, (c) Agoraphobic Cognitions Questionnaire (ACQ), and (d) Mobility Inventory (MI)-alone subscale.
Nonresponders to CBT (CGI-I >2; N = 6) - as compared to the responders (CGI-I ≤2; N = 15) - demonstrated significantly higher cortisol and ACTH basal plasma concentrations. These differences were much stronger when only female patients (nonresponders = 4; responders = 12) were taken into consideration. Regarding psychopathology, nonresponders to CBT suffered from more severe agoraphobia (MI-alone) at baseline. On the contrary, more intense manifestations of anger (SCL-90-R) at baseline were associated with a better treatment outcome. Response to CBT was associated with significant reductions in all SCL-90-R subscales, more pronounced for "phobic anxiety" and "anxiety" subscales.
This study suggests that in acutely ill, medication-free PD patients, response to CBT may be associated with certain hormonal and clinical parameters at baseline.
关于惊恐障碍（PD）心理治疗结果与生物学参数之间潜在关联的数据很少。在 21 名（16 名女性）连续转诊、未服用药物、急性发作、无合并症（除广场恐怖症外）的 PD 门诊患者中，我们系统地探索了对短暂认知行为疗法（CBT）的反应的潜在神经内分泌和临床相关性。
测量皮质醇和促肾上腺皮质激素（ACTH）基础血浆水平。心理病理学测量：（a）症状清单-90 修订版（SCL-90-R），（b）临床总体印象-改善（CGI-I）量表，（c）广场恐怖症认知问卷（ACQ），和（d）运动能力量表（MI）-单独分量表。
与 CBT 反应者（CGI-I ≤2；N = 15）相比，CBT 无反应者（CGI-I >2；N = 6）的皮质醇和 ACTH 基础血浆浓度显著更高。当仅考虑女性患者（无反应者 = 4；反应者 = 12）时，这些差异更明显。关于心理病理学，CBT 无反应者在基线时的广场恐怖症（MI-单独）更严重。相反，基线时更强烈的愤怒表现（SCL-90-R）与更好的治疗结果相关。CBT 的反应与所有 SCL-90-R 分量表的显著减少相关，对“恐惧症焦虑”和“焦虑”分量表的影响更为明显。
这项研究表明，在急性发作、未服用药物的 PD 患者中，CBT 的反应可能与基线时的某些激素和临床参数有关。
