Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-18T05:39:20.920Z Has data issue: false hasContentIssue false
  • English
  • Français

Empirically Supported Treatments for Panic Disorder with Agoraphobia in a Spanish Psychology Clinic

Published online by Cambridge University Press:  27 October 2014

Francisco Ballesteros  and
Francisco J. Labrador
Francisco Ballesteros
Affiliation:
Universidad Complutense (Spain)
Francisco J. Labrador*
Affiliation:
Universidad Complutense (Spain)
*
*Correspondence concerning this article should be addressed to Francisco Javier Labrador. Departamento de Psicología Clínica. Universidad Complutense de Madrid (Spain). Phone: +34–913942859. E-mail: labrador@cop.es
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this work is to study the sociodemographic and clinical characteristics of patients diagnosed with Panic Disorder with Agoraphobia (PD/Ag), as well as the characteristics of the treatment and its results and cost in a University Psychology Clinic. Fifty patients demanded psychological assistance for PD/Ag; 80% were women, with an average age of 29.22 years (SD = 9.03). Mean number of evaluation sessions was 3.26 (SD = 1.03), and of treatment sessions, 13.39 (SD = 9.237). Of the patients, 83.33% were discharged (that is, questionnaire scores were below the cut-off point indicated by the authors, and no PD/Ag was observed at readministration of the semistructured interview), 5.5% refused treatment, and 11% were dropouts. The average number of treatment sessions of patients who achieved therapeutic success was 15.13 (SD = 8.98). Effect sizes (d) greater than 1 were obtained in all the scales. Changes in all scales were significant (p < .05). The estimated cost of treatment for patients who achieved therapeutic success was 945.12€. The treatment results are at least similar to those of studies of efficacy and effectiveness for PD/Ag. The utility of generalizing treatments developed in research settings to a welfare clinic is discussed.

Keywords

panic with agoraphobiaefficacyeffectivenessempirically supported treatments
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 17 , 2014 , E65
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addis, M. E., Hatgis, C., Krasnow, A. D., Jacob, K., Bourne, L., & Mansfield, A. (2004). Effectiveness of cognitive-behavioral treatment for panic disorder versus treatment as usual in a managed care setting. Journal of Consulting and Clinical Psychology, 72, 625–635. http://dx.doi.org/10.1037/0022-006X.72.4.625 CrossRefGoogle Scholar
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4 th Ed., Rev.). Washington, DC: Author.Google Scholar
Bados, A. (2009). Agorafobia y pánico [Agoraphobia and panic]. Barcelona, Spain. Universidad de Barcelona.Google Scholar
Bakker, A., van Balkom, , , M. D., Anton, J. L. M., & van Dyck, R. (2000). Selective serotonin reuptake inhibitors in the treatment of panic disorder and agoraphobia. International Clinical Psychopharmacology, 15, 25–30.CrossRefGoogle ScholarPubMed
Baldwin, D. S., Anderson, I. M., Nutt, D. J., Bandelow, B., Bond, A., Davidson, J. R., … Wittchen, H. U. (2005). Evidence-based guidelines for the pharmacological treatment of anxiety disorders: Recommendations from the British association for psychopharmacology. Journal of Psychopharmacology, 19, 567–596. http://dx.doi.org/10.1177/0269881105059253 CrossRefGoogle ScholarPubMed
Barlow, D. H., & Craske, M. G. (1994). Mastery of your anxiety and panic - II. San Antonio, TX: The Psychological Corporation.Google Scholar
Barlow, D. H., Craske, M. G., Cerny, J. A., & Klosko, J. S. (1989). Behavioral treatment for panic disorder. Behavior Therapy, 20, 261–282. http://dx.doi.org/10.1016/S0005-7894(89)80073-5 CrossRefGoogle Scholar
Barlow, D. H., Esler, J. L., & Vitali, A. E. (2008). Psychosocial treatment for panic disorder, phobias and generalized anxiety disorder. In Nathan, P. E. & Gorman, J. M. (Eds.), A guide to treatments that work (pp. 288–318). New York, NY: Oxford University Press.Google Scholar
Boletín Oficial del Estado (2007). Orden SCO/3867/2007, por la que se determina los nuevos conjuntos de medicamentos y sus precios [Order SCO/3867/2007, establishing new sets of drugs and their prices]. (BOE Publication No. 312) Spain. Retrieved from http://www.boe.es/boe/dias/2007/12/29/pdfs/A53846-53890.pdf Google Scholar
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory - II. San Antonio, TX: Psychological Corporation.Google Scholar
Bravo, M. F. (2002). Psicofármacos para psicólogos [Psychotropic drugs for psychologists]. Madrid, Spain. Síntesis.Google Scholar
Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, L. E, Calhoun, K. S., Crits-Christoph, P., ... Woody, S. R. (1998). Update on empirically validated therapies II. The Clinical Psychologist, 51(1), 3–16.Google Scholar
Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090–1097. http://dx.doi.org/10.1037/0022-006X.52.6.1090 CrossRefGoogle ScholarPubMed
Clark, D. M. (1989). Anxiety states: Panic and generalized anxiety. In Hawton, K., Salkovskis, P. M., Kirk, J., & Clark, D. M. (Eds.), Cognitive behavior therapy for psychiatric problems. A practical guide (pp. 52–96). Oxford, UK: Oxford University Press.CrossRefGoogle Scholar
Clark, D. M., Salkovskis, P. M., Hackman, A., Middleton, H., Anastasiades, P., & Gelder, M. (1994). A comparison of cognitive therapy, applied relaxation and imipramine the treatment of panic disorder. British Journal of Psychiatric, 164, 759–769. http://dx.doi.org/10.1192/bjp.164.6.759 CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2 nd Ed.). Hillsdale, NJ: Elrbaum.Google Scholar
Comeche, M. I., Díaz, M. I., & Vallejo, M. A. (1995). Cuestionarios, inventarios y escalas: Ansiedad, depresión, habilidades sociales [Questionnaires, inventories and scales: Anxiety, depression, social skills]. Madrid, Spain: Fundación Universidad-Empresa.Google Scholar
Craske, M. G., & Barlow, D. H. (2007). Mastery of your anxiety and panic: Therapy guide (4 th Ed.). London, UK: Oxford University Press.Google Scholar
Hahlweg, K., Fiegenbaum, W., Frank, M., Schroeder, B., & von Witzleben, I. (2001). Short and long term effectiveness of an empirically supported treatment for agoraphobia. Journal of Consulting and Clinical Psychology, 69, 375–382. http://dx.doi.org/10.1037/0022-006X.69.3.375 CrossRefGoogle Scholar
Heuzenroeder, L., Donnelly, M., Haby, M. M, Mihalopoulos, C., Rossele, R., Andrews, G., & Vos, T. (2004). Cost-effectiveness of psychological interventions for generalized anxiety and panic disorder. Australian & New Zealand Journal of Psychiatry, 38, 602–612. http://dx.doi.org/10.1111/j.1440-1614.2004.01423.x CrossRefGoogle ScholarPubMed
Kenardy, J., Dow, M. G., Johnston, D. W., Newman, M. G., Thomson, A., & Taylor, C. B. (2003). A comparison of delivery of cognitive-behavioral therapy for panic disorder: An international multicenter trial. Journal of Consulting and Clinical Psychology, 71, 1068–1075. http://dx.doi.org/10.1037/0022-006X.71.6.1068 CrossRefGoogle ScholarPubMed
Labrador, F. J., & Ballesteros, F. (2011). Efectividad de los tratamientos para la fobia social en el ámbito aplicado [Effectiveness of treatments for social phobia in an applied setting]. Psicothema, 23, 560–565.Google Scholar
Labrador, F. J., Estupiña, F. J., & García-Vera, M. P. (2010). Demanda de atención psicológica en práctica clínica: Tratamiento y resultados [Psychological care demand in clinical practice: Treatment and results]. Psicothema, 22, 619–626.Google Scholar
Ministerio de Sanidad y Consumo (2006). Propuesta de estrategia en salud mental del Sistema Nacional de Salud [Proposal of mental health strategy of the National Health System]. Madrid, Spain: Ministerio de Consumo, Centro de Publicaciones.Google Scholar
Mitte, K. (2005). A meta-analysis of the efficacy of psycho- and pharmacotherapy in panic disorder with and without agoraphobia. Journal of Affective Disorder, 88, 27–45. http://dx.doi.org/10.1016/j.jad.2005.05.003 CrossRefGoogle ScholarPubMed
Muñoz, M. (2003). Manual práctico de evaluación psicológica clínica [Practical handbook of clinical psychological assessment]. Madrid, Spain: Síntesis.Google Scholar
Öst, L-G., Thulin, U., & Ramnerö, J. (2004). Cognitive behavior therapy vs. exposure in vivo in treatment of panic disorder with agoraphobia. Behaviour Research and Therapy, 42, 1105–1127. http://dx.doi.org/10.1016/j.brat.2003.07.004 CrossRefGoogle ScholarPubMed
Otto, M. W., Pollack, M. H., & Maki, K. M. (2000). Empirically supported treatments for panic disorder: Costs, benefits and stepped care. Journal of Consulting and Clinical Psychology, 68, 556–563. http://dx.doi.org/10.1037/0022-006X.68.4.556 CrossRefGoogle ScholarPubMed
Rosenberg, M. K., & Hougaard, E. (2005). Cognitive-behavioral group treatment of panic disorder and agoraphobia in a psychiatric setting: A naturalistic study of effectiveness. Nordic Journal of Psychiatry, 59, 198–204. http://dx.doi.org/10.1080/08039480510027670 CrossRefGoogle Scholar
Ruhmland, M., & Margraf, J. (2001). Efficacy of psychological therapy for panic and agoraphobia: Meta-analysis of the level of troubles. Verhaltenstherapie, 11, 41–53. http://dx.doi.org/10.1159/000050323 CrossRefGoogle Scholar
Sanz, J., Perdigón, L. A., & Vázquez, C. (2003). Adaptación española del Inventario para la Depresión de Beck-II (BDI-II): 2. Propiedades psicométricas en población general [Spanish adaptation of the Beck Depression Inventory-II (BDI-II): Psychometric properties in general population]. Clínica y Salud, 14, 249–280.Google Scholar
Van Apeldoorn, F., van Hout, W., Mersch, P., Huisman, M., Slaap, B., Hale, W., … den Boer, J. A. (2008). Is a combined therapy more effective than either CBT or SSRI alone? Result of a multicenter trial on panic disorder with or without agoraphobia. Acta Psychiatrica Scandinavica, 117, 260–270. http://dx.doi.org/10.1111/j.1600-0447.2008.01157.x CrossRefGoogle ScholarPubMed
Wade, W. A., Treat, T. A., & Stuart, G. L. (1998). Transporting an empirically supported treatment for panic disorder to a service clinic setting: A benchmarking strategy. Journal of Consulting Clinic Psychology, 66, 231–239. http://dx.doi.org/10.1037/0022-006X.66.2.231 CrossRefGoogle ScholarPubMed