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Changes in quality of life following cognitive-behavioral group therapy for panic disorder

Published online by Cambridge University Press:  16 April 2020

M. Rufer*
Affiliation:
Department of Psychiatry, University Hospital of Zürich, Culmannstrasse 8 8091Zürich, Switzerland
R. Albrecht
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany
O. Schmidt
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany
J. Zaum
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany
U. Schnyder
Affiliation:
Department of Psychiatry, University Hospital of Zürich, Culmannstrasse 8 8091Zürich, Switzerland
I. Hand
Affiliation:
Department of Psychiatry and Psychotherapy, University Hospital of Hamburg, Hamburg, Germany
C. Mueller-Pfeiffer
Affiliation:
Department of Psychiatry, University Hospital of Zürich, Culmannstrasse 8 8091Zürich, Switzerland Center of Education and Research, Psychiatric Services of the County of St., Gallen-North Wil SG, Switzerland
*
*Corresponding author. Tel.: +41 (0)44 255 5280; fax: +41 (0)44 255 4408. E-mail address: [email protected] (M. Rufer).
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Abstract

Background

Data about quality of life (QoL) are important to estimate the impact of diseases on functioning and well-being. The present study was designed to assess the association of different aspects of panic disorder (PD) with QoL and to examine the relationship between QoL and symptomatic outcome following brief cognitive-behavioral group therapy (CBGT).

Methods

The sample consisted of 55 consecutively recruited outpatients suffering from PD who underwent CBGT. QoL was assessed by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) at baseline, post-treatment and six months follow-up. SF-36 baseline scores were compared with normative data obtained from a large German population sample.

Results

Agoraphobia, disability, and worries about health were significantly associated with decreased QoL, whereas frequency, severity and duration of panic attacks were not. Treatment responders showed significantly better QoL than non-responders. PD symptom reduction following CBGT was associated with considerable improvement in emotional and physical aspects of QoL. However, the vitality subscale of the SF-36 remained largely unchanged over time.

Conclusions

Our results are encouraging for cognitive-behavior therapists who treat patients suffering from PD in groups, since decrease of PD symptoms appears to be associated with considerable improvements in QoL. Nevertheless, additional interventions designed to target specific aspects of QoL, in particular vitality, may be useful to enhance patients’ well-being.

Type
Original articles
Copyright
Copyright © Elsevier Masson SAS 2010

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References

Ackenheil, M., Stotz, G., Dietz-Bauer, R., Vossen, A.Mini International Interview - German Version 5.0.0. Germany: Psychiatrische Universitätsklinik München; 1999.Google Scholar
Alsleben, H., Weiss, A., Rufer, M.Psychoedukation Angst- und Panikstörungen. Manual zur Leitung von Patienten- und Angehörigengruppen. München: Elsevier Urban & Fischer; 2004.Google Scholar
Arntz, A.Cognitive therapy versus interoceptive exposure as treatment of panic disorder without agoraphobia. Behav Res Ther 2002;40:325341.CrossRefGoogle ScholarPubMed
Bandelow, B.Assessing the efficacy of treatments for panic disorder and agoraphobia. II. The Panic and Agoraphobia Scale. Int Clin Psychopharmacol 1995;10:7381.CrossRefGoogle ScholarPubMed
Bandelow, B.Panik- und Agoraphobia-Skala (PAS). Göttingen: Hogrefe; 1997.Google Scholar
Bandelow, B., Broocks, A., Pekrun, G., George, A., Meyer, T., Pralle, L.et al. The use of the Panic and Agoraphobia Scale (P & A) in a controlled clinical trial. Pharmacopsychiatry 2000;33:174181.CrossRefGoogle Scholar
Bandelow, B., Brunner, E., Broocks, A., Beinroth, D., Hajak, G., Pralle, L.et al. The use of the Panic and Agoraphobia Scale in a clinical trial. Psychiatry Res 1998;77:4349.CrossRefGoogle ScholarPubMed
Bandelow, B., Stein, D.J., Dolberg, O.T., Andersen, H.F., Baldwin, D.S.Improvement of quality of life in panic disorder with escitalopram, citalopram, or placebo. Pharmacopsychiatry 2007;40:152156.CrossRefGoogle ScholarPubMed
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J., Erbaugh, J.An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561571.CrossRefGoogle ScholarPubMed
Bullinger, M., Kirchberger, I.SF-36 Fragebogen zum Gesundheitszustand. Göttingen: Hogrefe; 1998.Google Scholar
Candilis, P.J., McLean, R.Y., Otto, M.W., Manfro, G.G., Worthington, J.J. 3rd Penava, S.J.et al. Quality of life in patients with panic disorder. J Nerv Ment Dis 1999;187:429434.CrossRefGoogle ScholarPubMed
Carrera, M., Herran, A., Ayuso-Mateos, J.L., Sierra-Biddle, D., Ramirez, M.L., Ayestaran, A.et al. Quality of life in early phases of panic disorder: predictive factors. J Affect Disord 2006;94:127134.CrossRefGoogle ScholarPubMed
Cohen, D.Statistical Power Analysis for Behavioral Sciences. Hillsdale: Erlbaum; 1988.Google Scholar
Dow, M.G., Kenardy, J.A., Johnston, D.W., Newman, M.G., Taylor, C.B., Thomson, A.Prognostic indices with brief and standard CBT for panic disorder: I. Predictors of outcome. Psychol Med 2007;37:14931502.CrossRefGoogle ScholarPubMed
Dow, M.G., Kenardy, J.A., Johnston, D.W., Newman, M.G., Taylor, C.B., Thomson, A.Prognostic indices with brief and standard CBT for panic disorder: II. Moderators of outcome. Psychol Med 2007;37:15031509.CrossRefGoogle Scholar
Eaton, W.W., Kessler, R.C., Wittchen, H.U., Magee, W.J.Panic and panic disorder in the United States. Am J Psychiatry 1994;151:413420.Google ScholarPubMed
Ettigi, P., Meyerhoff, A.S., Chirban, J.T., Jacobs, R.J., Wilson, R.R.The quality of life and employment in panic disorder. J Nerv Ment Dis 1997;185:368372.CrossRefGoogle ScholarPubMed
Fava, G.A.Well-being therapy: conceptual and technical issues. Psychother Psychosom 1999;68:171179.CrossRefGoogle ScholarPubMed
Fava, G.A., Rafanelli, C., Ottolini, F., Ruini, C., Cazzaro, M., Grandi, S.Psychological well-being and residual symptoms in remitted patients with panic disorder and agoraphobia. J Affect Disord 2001;65:185190.CrossRefGoogle ScholarPubMed
Fava, G.A., Rafanelli, C., Tossani, E., Grandi, S.Agoraphobia is a disease: a tribute to Sir Martin Roth. Psychother Psychosom 2008;77:133138.CrossRefGoogle ScholarPubMed
Fava, G.A., Ruini, C., Rafanelli, C., Finos, L., Salmaso, L., Mangelli, L.et al. Well-being therapy of generalized anxiety disorder. Psychother Psychosom 2005;74:2630.CrossRefGoogle ScholarPubMed
Furukawa, T.A., Watanabe, N., Churchill, R.Psychotherapy plus antidepressant for panic disorder with or without agoraphobia: systematic review. Br J Psychiatry 2006;188:305312.CrossRefGoogle ScholarPubMed
Fyer, A.J., Katon, W., Hollifield, M., Rassnick, H., Mannuzza, S., Chapman, T.et al. The DSM-IV panic disorder field trial: panic attack frequency and functional disability. Anxiety 1996;2:157166.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Heldt, E., Blaya, C., Isolan, L., Kipper, L., Teruchkin, B., Otto, M.W.et al. Quality of life and treatment outcome in panic disorder: cognitive behavior group therapy effects in patients refractory to medication treatment. Psychother Psychosom 2006;75:183186.CrossRefGoogle ScholarPubMed
Hoehn-Saric, R., McLeod, D.R., Hipsley, P.A.Effect of fluvoxamine on panic disorder. J Clin Psychopharmacol 1993;13:321326.CrossRefGoogle ScholarPubMed
Hollifield, M., Katon, W., Skipper, B., Chapman, T., Ballenger, J.C., Mannuzza, S.et al. Panic disorder and quality of life: variables predictive of functional impairment. Am J Psychiatry 1997;154:766772.Google ScholarPubMed
Jacobs, R.J., Davidson, J.R., Gupta, S., Meyerhoff, A.S.The effects of clonazepam on quality of life and work productivity in panic disorder. Am J Manag Care 1997;3:11871196.Google ScholarPubMed
Katon, W., Hollifield, M., Chapman, T., Mannuzza, S., Ballenger, J., Fyer, A.Infrequent panic attacks: psychiatric comorbidity, personality characteristics and functional disability. J Psychiatr Res 1995;29:121131.CrossRefGoogle ScholarPubMed
Kenardy, J.A., Dow, M.G., Johnston, D.W., Newman, M.G., Thomson, A., Taylor, C.B.A comparison of delivery methods of cognitive-behavioral therapy for panic disorder: an international multicenter trial. J Consult Clin Psychol 2003;71:10681075.CrossRefGoogle Scholar
Kiropoulos, L.A., Klein, B., Austin, D.W., Gilson, K., Pier, C., Mitchell, J.et al. Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT?. J Anxiety Disord 2008;22:12731284.CrossRefGoogle ScholarPubMed
Lecrubier, Y., Judge, R.Long-term evaluation of paroxetine, clomipramine and placebo in panic disorder. Collaborative Paroxetine Panic Study Investigators. Acta Psychiatr Scand 1997;95:153160.CrossRefGoogle ScholarPubMed
Markowitz, J.S., Weissman, M.M., Ouellette, R., Lish, J.D., Klerman, G.L.Quality of life in panic disorder. Arch Gen Psychiatry 1989;46:984992.CrossRefGoogle ScholarPubMed
Mavissakalian, M.R., Perel, J.M., Talbott-Green, M., Sloan, C.Gauging the effectiveness of extended imipramine treatment for panic disorder with agoraphobia. Biol Psychiatry 1998;43:848854.CrossRefGoogle ScholarPubMed
McHorney, C.A., Ware, J.E. Jr., Raczek, A.E.The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31:247263.CrossRefGoogle ScholarPubMed
Mendlowicz, M.V., Stein, M.B.Quality of life in individuals with anxiety disorders. Am J Psychiatry 2000;157:669682.CrossRefGoogle ScholarPubMed
Michelson, D., Lydiard, R.B., Pollack, M.H., Tamura, R.N., Hoog, S.L., Tepner, R.et al. Outcome assessment and clinical improvement in panic disorder: evidence from a randomized controlled trial of fluoxetine and placebo. The Fluoxetine Panic Disorder Study Group. Am J Psychiatry 1998;155:15701577.CrossRefGoogle ScholarPubMed
Moritz, S., Rufer, M., Fricke, S., Karow, A., Morfeld, M., Jelinek, L.et al. Quality of life in obsessive-compulsive disorder before and after treatment. Compr Psychiatry 2005;46:453459.CrossRefGoogle ScholarPubMed
Mortimer, D., Segal, L.Comparing the incomparable? A systematic review of competing techniques for converting descriptive measures of health status into QALY-weights. Med Decis Making 2008;28:6689.CrossRefGoogle ScholarPubMed
Olatunji, B.O., Cisler, J.M., Tolin, D.F.Quality of life in the anxiety disorders: a meta-analytic review. Clin Psychol Rev 2007;27:572581.CrossRefGoogle ScholarPubMed
Pohl, R.B., Wolkow, R.M., Clary, C.M.Sertraline in the treatment of panic disorder: a double-blind multicenter trial. Am J Psychiatry 1998;155:11891195.CrossRefGoogle ScholarPubMed
Pollack, M.H., Otto, M.W., Worthington, J.J., Manfro, G.G., Wolkow, R.Sertraline in the treatment of panic disorder: a flexible-dose multicenter trial. Arch Gen Psychiatry 1998;55:10101016.CrossRefGoogle ScholarPubMed
Rapaport, M.H., Pollack, M., Wolkow, R., Mardekian, J., Clary, C.Is placebo response the same as drug response in panic disorder?. Am J Psychiatry 2000;157:10141016.CrossRefGoogle ScholarPubMed
Roy-Byrne, P.P., Craske, M.G., Stein, M.B.Panic disorder. Lancet 2006;368:10231032.CrossRefGoogle ScholarPubMed
Ruhmland, M., Margraf, J.Efficacy of psychological treatments for panic and agoraphobia. Verhaltenstherapie 2001;11:4153.CrossRefGoogle Scholar
Schonfeld, W.H., Verboncoeur, C.J., Fifer, S.K., Lipschutz, R.C., Lubeck, D.P., Buesching, D.P.The functioning and well-being of patients with unrecognized anxiety disorders and major depressive disorder. J Affect Disord 1997;43:105119.CrossRefGoogle ScholarPubMed
Shao, J., Zhong, B.Last observation carry-forward and last observation analysis. Stat Med 2003;22:24292441.CrossRefGoogle ScholarPubMed
Sheehan, D.V.The anxiety disease. New York: Charles Scribner's Sons; 1983.Google Scholar
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E.et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59:2233.Google ScholarPubMed
Telch, M.J., Schmidt, N.B., Jaimez, T.L., Jacquin, K.M., Harrington, P.J.Impact of cognitive-behavioral treatment on quality of life in panic disorder patients. J Consult Clin Psychol 1995;63:823830.CrossRefGoogle ScholarPubMed
Tsai, C., Bayliss, M.S., Ware, J.E.SF-36 Health Survey Annotated Bibliography. 2nd Edition Boston: Health Assessment Lab, New England Medical Center; 1997.Google Scholar
Ware, J.E., Gandek, B., IQOLA-Project-Group. The SF-36 Health Survey: development and use in mental health research and the IQOLA Project. Int J Ment Health 1994;23:4973.CrossRefGoogle Scholar
Ware, J.E., Sherbourne, C.D.The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473483.CrossRefGoogle ScholarPubMed
Ware, J.E., Snow, K.K., Kosinski, M., Gandek, B.SF-36 Health Survey Manual and Interpretation Guide. Boston: New England Medical Center, The Health Institute; 1993.Google Scholar
Weissman, M.M., Prusoff, B.A., Thompson, W.D., Harding, P.S., Myers, J.K.Social adjustment by self-report in a community sample and in psychiatric outpatients. J Nerv Ment Dis 1978;166:317326.CrossRefGoogle Scholar
WHOQOL-Group Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28:551558.CrossRefGoogle Scholar
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