Arntz A, van den Hout M
Department of Medical Psychology, University of Limburg, Maastricht, The Netherlands.
Behav Res Ther. 1996 Feb;34(2):113-21. doi: 10.1016/0005-7967(95)00061-5.
This study compared two psychological treatments of panic disorder and tested whether cognitive therapy (CT) was superior to applied relaxation (AR); and whether treatment was superior to waiting. Thirty-six outpatients of the community mental health center with the DSM-III-R diagnosis of panic disorder with no or mild agoraphobia were randomly assigned to CT or AR. Eighteen similar patients who were referred after the treatment conditions were complete constituted a waiting-list group. Treatment consisted of 12 weekly sessions. Patients self-monitored panic attacks during the whole treatment period, and the following 4 weeks, and during 1 week at a half-year follow-up. Questionnaires were filled out before and after treatment, and at 4-week and half-year follow-ups. After the first follow-up additional treatment was provided if clinically indicated. One patient dropped out of AR and was replaced. Treatment was superior to waiting in reducing panic and questionnaire scores. CT was clearly superior to AR in reducing panic frequency, and somewhat less strongly superior to AR in reducing the questionnaire scores. Depending on the assessment point, 77.8-83.3% of the CT patients was panic-free after treatment, compared to 50% of the AR and 27.7% of the waiting-list patients. In conclusion, cognitive therapy for panic is especially effective in reducing the incidence of panic attacks.
本研究比较了惊恐障碍的两种心理治疗方法，并测试认知疗法（CT）是否优于应用放松疗法（AR）；以及治疗是否优于等待。三十六名社区心理健康中心的门诊患者，根据《精神疾病诊断与统计手册第三版修订版》被诊断为无或轻度广场恐怖症的惊恐障碍，被随机分配到CT组或AR组。在治疗条件结束后转诊的十八名类似患者组成了一个等待名单组。治疗包括每周一次的十二节课程。患者在整个治疗期间、接下来的四周以及半年随访的一周内自我监测惊恐发作情况。在治疗前后、四周和半年随访时填写问卷。在首次随访后，如果有临床指征则提供额外治疗。一名AR组患者退出并被替换。在减少惊恐和问卷得分方面，治疗优于等待。在减少惊恐发作频率方面，CT明显优于AR，在减少问卷得分方面，CT比AR略胜一筹。根据评估点，治疗后77.8 - 83.3%的CT组患者无惊恐发作，相比之下，AR组为50%，等待名单组为27.7%。总之，惊恐障碍的认知疗法在降低惊恐发作发生率方面特别有效。
