FOLLOW-UP ON THE TREATMENT OF PANIC DISORDER WITH OR WITHOUT AGORAPHOBIA - A QUANTITATIVE REVIEW

We conducted a meta-analysis to update the knowledge of long-term effi cacy of different treatments in panic disorder with or without agoraph obia Included were 68 studies pertaining to 106 treatment conditions a nd 1316 patients. Effect sizes Cohen's d were calculated within the tr eatment conditions at posttest and at follow-up for panic and agorapho bia A comparison was made between six treatments: high-potency benzodi azepines, antidepressants, psychological panic management, exposure in vivo, antidepressants combined with exposure! and psychological panic management combined with exposure in vivo. The mean (+/- SD) duration of the follow-up period was 62 +/- 89 weeks. In the majority of the s tudies (84%), follow-up had a naturalistic character. The lack of info rmation about treatments received bet between posttest and follow-up l imits the interpretation of the results. For all conditions, the treat ment gains at posttest were maintained during the follow-up period. Th e mean (+/- SD) d for panic was 1.11 +/- 0.70 at posttest and 1.28 +/- 0.61 at follow-up; for agoraphobia, the mean d at posttest was 1.36 /- 1.10 and at follow-up it was 1.41 +/- 0.82. Significant differences were found in efficacy on agoraphobic measures at follow-up between t he combination of antidepressants and exposure in vivo versus psycholo gical panic management, exposure in vivo, and the combination of psych ological panic management and exposure. Overall, the data suggest that different treatment options for panic disorder with or without agorap hobia are effective at both posttest and follow-up. Research on long-t erm treatment, discontinuation of therapies, and intentions between po sttest and follow-up need more attention, for pharmacotherapy as well as psychotherapy.