Cognitive behavior therapy in panic disorder and comorbid major depression- A naturalistic study

Background: There is a lack of evidence about the effectiveness of cognitiv e behavior therapies (CBT) in settings of routine clinical care as well as in the treatment of panic and comorbid disorders. Methods: We investigated a group-oriented CBT approach for 80 patients with panic disorder including 35 patients with current comorbid major depressio n. Assessments took place 6 months before treatment, at the beginning and e nd of treatment, and 1 year later. Structured interviews and multiple clini cal self-rating scales were used. Results: Panic patients with comorbid major depression showed higher anxiet y-specific and nonspecific pathology. The most striking benefits were in re ducing avoidance behavior, while improvements concerning catastrophic belie fs were smaller, but still significant. For most self-rating scale results, patients with and without comorbid depression improved to a comparable deg ree. However, the end-state functioning of patients with panic disorder and current comorbid depression at admission is significantly lower than for p atients with panic disorder alone, Conclusions: The results point to the necessity to develop and improve trea tment approaches for patients with comorbidity of panic disorder and curren t major depression. Copyright (C) 2000 S.Karger AG, Basel.