DOES BRIEF DYNAMIC PSYCHOTHERAPY REDUCE THE RELAPSE RATE OF PANIC DISORDER

Background: Although panic disorder can be effectively alleviated by d rug treatment, the relapse rate is high. By adding brief dynamic psych otherapy focused on the psychosocial vulnerability of patients with pa nic 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 rand omized to treatment with either clomipramine for 9 months (n=20), or c lomipramine for 9 months combined with 15 weekly sessions of brief dyn amic psychotherapy (n=20). Measures of anxiety and depression were col lected at intake and at regular intervals. The patients had blind foll ow-up interviews at 6, 12, and 18 months after beginning treatment. Re sults: 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 g roup during the follow-up period. There were significantly lower score s for most anxiety measures in the clomipramine plus psychotherapy gro up at the 9-month follow-up. Conclusion: The addition of brief dynamic psychotherapy to treatment with clomipramine significantly reduces th e relapse rate of panic disorder compared with clomipramine treatment alone.