Panic Disorder with or without or without agoraphobia (PD/A) is common and can be treated effectively with SSRI medication or cognitive behaviour therapy (CBT). However, a great challenge is generally the lack of skilled CBT therapists. Therefore, there has been a move toward evaluating different forms of self-help approaches requiring less therapist contact than in traditional CBT. A novel treatment modality in this field, showing efficacy in several randomised trials, but until yet not evauated within regular care, is Internet-based treatment.

The aim of these two studies was to evaluate the effectiveness of Internet-based CBT for PD within regular care with patients referred for treatment.

We have conducted two trials. The first trial was a small open study including 20 patients and the second is a larger randomised trial comparing Internet-CBT with group CBT. The Internet-CBT consisted of 10 weekly modules accompanied by e-mail support. In the randomised trial, the group CBT included the same self-help material administered during 10 group sessions.

The results of these trials indicate that Internet-based CBT is both an effective and potentially cost-effective alternative for patients with PD, in both trials showing a clinically significant effect on PD-symptoms measured by the clinician rated Panic Disorder Severity Scale. Moreover, preliminary data from the randomised trial show no significant differences in effect between Internet- or group-delivered CBT.

Our work suggests the possibility of markedly increasing the access to evidence-based psychological treatment within regular psychiatric care by using the internet as treatment medium.