School of Psychology, Université Laval, 2325 rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
Research Center of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, 143 rue Wolfe, Lévis, QC, G6V 3Z1, Canada.
J Clin Psychol Med Settings. 2023 Mar;30(1):28-42. doi: 10.1007/s10880-022-09876-7. Epub 2022 May 11.
Implementing cognitive-behavioral therapy (CBT), the first-line psychological treatment for panic disorder (PD), may be challenging in patients with comorbid coronary artery disease (CAD).This study aimed at assessing the feasibility and acceptability of a CBT for PD protocol that was adapted to patients suffering from comorbid CAD. It also aimed at evaluating the efficacy of the intervention to reduce PD symptomatology and psychological distress and improve quality of life. This was a single-case experimental design with pre-treatment, post-treatment and 6-month follow-up measures. Patients with PD and stable CAD received 14 to 17 individual, 1-h sessions of an adapted CBT for PD protocol. They completed interviews and questionnaires at pre-treatment, post-treatment and at a 6-month follow-up assessing intervention acceptability, PD symptomatology, psychological distress and quality of life. A total of 6 patients out of 7 completed the intervention and 6-month follow-up, indicating satisfactory feasibility. Acceptability was high (medians of ≥ 8.5 out of 9 and ≥ 80%) both at pre and post treatment. Remission rate was of 83% at post-treatment and 6-month follow-up. The intervention appeared to have positive effects on comorbid anxiety and depression symptoms and quality of life. The intervention appeared feasible and acceptable in patients with comorbid CAD. The effects of the adapted CBT protocol on PD symptoms, psychological distress and quality of life are promising and were maintained at the 6-month follow-up. Further studies should aim at replicating the present results in randomized-controlled trials.
实施认知行为疗法（CBT），即惊恐障碍（PD）的一线心理治疗方法，可能对同时患有冠状动脉疾病（CAD）的患者具有挑战性。本研究旨在评估一种适应于同时患有 CAD 的 PD 患者的 CBT 方案的可行性和可接受性。它还旨在评估干预措施对减轻 PD 症状、心理困扰和改善生活质量的疗效。这是一项单病例实验设计，包括治疗前、治疗后和 6 个月随访的措施。患有 PD 和稳定 CAD 的患者接受了 14-17 次个体化、1 小时的适应 PD 的 CBT 方案。他们在治疗前、治疗后和 6 个月随访时完成了访谈和问卷调查，评估干预的可接受性、PD 症状、心理困扰和生活质量。7 名患者中有 6 名完成了干预和 6 个月随访，表明可行性良好。在治疗前和治疗后，可接受性均很高（中位数均为 9 分以上和 80%以上）。治疗后和 6 个月随访时的缓解率分别为 83%和 67%。该干预措施似乎对共病焦虑和抑郁症状以及生活质量有积极影响。该适应 CBT 方案在同时患有 CAD 的患者中具有可行性和可接受性。该方案对 PD 症状、心理困扰和生活质量的影响是有希望的，并且在 6 个月随访时得到了维持。进一步的研究应该旨在在随机对照试验中复制目前的结果。
