School of Psychology, University of New South Wales Sydney, NSW 2052, Australia; Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW 2010, Australia.
School of Psychiatry, University of New South Wales Sydney, NSW 2052, Australia; Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Sydney, NSW 2010, Australia.
J Anxiety Disord. 2021 Apr;79:102382. doi: 10.1016/j.janxdis.2021.102382. Epub 2021 Mar 10.
To compare the efficacy and acceptability of internet-delivered exposure therapy for panic disorder, to multi-component internet-delivered cognitive behavioral therapy (iCBT) that included controlled breathing, cognitive restructuring and exposure.
Participants with panic disorder, with or without agoraphobia, were randomized to internet-delivered exposure therapy (n = 35) or iCBT (n = 34). Both programs were clinician guided, with six lessons delivered over eight weeks. Outcomes included panic disorder and agoraphobia symptom severity, as well as depression symptom severity, functional impairment and days out of role.
Participants in both conditions displayed a large reduction in panic disorder symptom severity (ds >1.30) from pre- to post-treatment. Participants in both conditions displayed medium to large reduction in agoraphobia and depression symptom severity, functional impairment and days out of role. Effects were maintained at three- and six-month follow-up. There was no significant difference between the interventions in clinical outcomes, adherence or treatment satisfaction.
Internet-delivered exposure therapy appeared to be as acceptable and efficacious as more established iCBT, despite including less strategies. However, a fully powered replication is now needed to compare the two approaches.
比较互联网为基础的暴露疗法治疗惊恐障碍的疗效和可接受性，与包括控制呼吸、认知重构和暴露在内的多成分的互联网为基础的认知行为疗法（iCBT）。
患有惊恐障碍（伴或不伴广场恐怖症）的参与者被随机分配到互联网为基础的暴露疗法（n=35）或 iCBT（n=34）。两种方案均由临床医生指导，在八周内提供六节课。结果包括惊恐障碍和广场恐怖症症状严重程度，以及抑郁症状严重程度、功能障碍和角色缺失天数。
两种条件下的参与者在治疗前至治疗后的惊恐障碍症状严重程度均有较大的降低（ds>1.30）。两种条件下的参与者在广场恐怖症和抑郁症状严重程度、功能障碍和角色缺失天数方面均有中度至较大的降低。在三个月和六个月的随访中，效果仍然保持。在临床结果、依从性或治疗满意度方面，干预措施之间没有显著差异。
尽管互联网为基础的暴露疗法包含的策略较少，但它似乎与更成熟的 iCBT 一样可接受和有效。然而，现在需要进行一项充分的复制研究来比较这两种方法。
