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Question
Question
What is the long-term effectiveness of cognitive behavioural therapy (CBT), pharmacotherapy using a selective serotonin reuptake inhibitor (SSRI) or the combination of both for panic disorder with or without agoraphobia?
Patients
150 adults with a primary diagnosis of DSM-IV panic disorder with or without DSM-III-R agoraphobia (based on Mini-International Neuropsychiatric Interview). The study excluded people who were pregnant, lactating, suicidal, psychotic or severely depressed.
Setting
11 treatment centres in the Netherlands; enrolment April 2001 to September 2003.
Intervention
CBT, SSRI or both for 1 year. CBT consisted of up to 21 sessions lasting 50 min. Participants receiving SSRIs had up to 12 sessions with their therapist and tapered their medication over 3 months at the end of treatment. Participants were classed as completers, dropouts or no-tapers. Those who received a minimum of 15 CBT sessions and/or eight SSRI sessions and ended treatment with therapist consent were considered completers. Dropouts received less than 1 year's treatment. No-tapers did not taper off their SSRI medication.
Outcomes
General aspects of anxiety (Hamilton Anxiety Rating Scale score range 0–56, higher …
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