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Ida M. Wiborg, PhD; Alv A. Dahl, MD, PhD

Arch Gen Psychiatry. 1996;53(8):689-694.

Abstract
Background
Although panic disorder can be effectively alleviated by drug treatment, the relapse rate is high. By adding brief dynamic psychotherapy focused on the Psychosocial vulnerability of patients with panic disorder to an established drug treatment regimen, we hypothesized that this would result in a lower relapse rate after pharmacotherapy.

Methods
Patients with panic disorder (defined by DSM-III-R) were randomized to treatment with either clomipramine for 9 months (n=20), or clomipramine for 9 months combined with 15 weekly sessions of brief dynamic psychotherapy (n=20). Measures of anxiety and depression were collected at intake and at regular intervals. The patients had blind follow-up interviews at 6, 12, and 18 months after beginning treatment.

Results
All patients in both groups became free of panic attacks within 26 weeks of the start of treatment. On termination of pharmacotherapy, the relapse rate was significantly higher in the clomipramine-only group during the follow-up period. There were significantly lower scores for most anxiety measures in the clomipramine plus psychotherapy group at the 9-month follow-up.

Conclusion
The addition of brief dynamic psychotherapy to treatment with clomipramine significantly reduces the relapse rate of panic disorder compared with clomipramine treatment alone.

Author Affiliations
From the Research Unit, Aker Hospital, Division of Psychiatry, University of Oslo, Oslo, Norway.

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