Hahnfeld Malte, Ritter Philipp, Sauer Cathrin, Weidner Kerstin, Noack René
Klinik und Poliklinik für Psychotherapie und Psychosomatik, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Nervenarzt. 2023 Sep;94(9):842-848. doi: 10.1007/s00115-023-01535-y. Epub 2023 Aug 29.
Cognitive behavioral therapy (CBT) and pharmacotherapy with antidepressants are both a highly effective treatment for agoraphobia and/or panic disorder; however, a combination of CBT and antidepressants is under debate due to potentially unfavorable interference effects. The associations of existing antidepressant medication with panic and agoraphobia symptom burden and their change in the context of a structured 5‑week day hospital and exposure-focused treatment in a naturalistic setting were investigated.
Out of a total of n = 488 patients medication use during treatment was retrospectively determined for n = 380: n = 100 (26.3%) were taking antidepressants of different drug classes. Calculations were performed using multiple linear regression analysis, t‑tests, response analyses, and χ-tests.
Patients with existing antidepressant medication more often met the criteria for comorbid depressive disorder (p < 0.001). The measure of symptom change and treatment response rates did not differ between patients with and without antidepressants with respect to anxiety symptoms.
In the context studied, patients with and without existing antidepressant medication benefited equally from CBT with respect to anxiety symptoms.
认知行为疗法（CBT）和抗抑郁药物治疗对广场恐惧症和/或惊恐障碍均为高效治疗方法；然而，由于可能存在不利的干扰效应，CBT与抗抑郁药物联合使用仍存在争议。本研究调查了现有抗抑郁药物与惊恐和广场恐惧症症状负担的关联，以及在结构化的为期5周的日间医院环境和自然环境中以暴露为重点的治疗背景下它们的变化情况。
在总共n = 488例患者中，对n = 380例患者治疗期间的用药情况进行了回顾性确定：n = 100例（26.3%）正在服用不同药物类别的抗抑郁药。使用多元线性回归分析、t检验、反应分析和χ检验进行计算。
正在服用抗抑郁药物的患者更常符合共病抑郁症的标准（p < 0.001）。在焦虑症状方面，服用和未服用抗抑郁药的患者在症状变化测量和治疗反应率上没有差异。
在所研究的背景下，无论是否正在服用抗抑郁药物，患者在焦虑症状方面从CBT中获得的益处相同。
