A feasibility study of the clinical effectiveness and cost-effectiveness of individual cognitive behavioral therapy for panic disorder in a Japanese clinical setting: an uncontrolled pilot study.

Akiko Nakagawa,Naoki Yoshinaga,Mizue Yokoo,Yasushi Inada,Shinobu Nagata,Hanae Ibuki,Yoichi Seki,Eiji Shimizu,Muga Kusunoki,Noriko Minamitani,Nobuko Kawasoe,Masaomi Iyo,Soichiro Adachi,Michiko Nakazato,Kensuke Yoshimura,Takayuki Shibuya

doi:10.1186/s13104-016-2262-5

Abstract

BackgroundIn Japan, cognitive behavioral therapy (CBT) for panic disorder (PD) is not well established. Therefore, a feasibility study of the clinical effectiveness and cost-effectiveness of CBT for PD in a Japanese clinical setting is urgently required. This was a pilot uncontrolled trial and the intervention consisted of a 16-week CBT program. The primary outcome was Panic Disorder Severity Scale (PDSS) scores. Quality of life was assessed using the EuroQol’s EQ-5D questionnaire. Assessments were conducted at baseline, 8 weeks, and at the end of the study. Fifteen subjects completed outcome measures at all assessment points.ResultsAt post-CBT, the mean reduction in PDSS scores from baseline was −6.6 (95 % CI 3.80 to −9.40, p < 0.001) with a Cohen’s d = 1.77 (95 % CI 0.88–2.55). Ten (66.7 %) participants achieved a 40 % or greater reduction in PDSS. By calculating areas under the curve for EQ-5D index changes, we estimated that patients gained a minimum of 0.102 QALYs per 1 year due to the CBT.ConclusionsThis study demonstrated that individual CBT for PD may be useful in Japanese clinical settings but further randomized control trials are needed. Trial registration: UMIN-CTR UMIN000022693 (retrospectively registered)

Highlights

In Japan, cognitive behavioral therapy (CBT) for panic disorder (PD) is not well established
Regarding the primary outcome, in the acute phase after treatment, the change in Panic Disorder Severity Scale (PDSS) score that we found was comparable to those that we calculated for a previous clinical trial conducted by Barlow et al [10]
One possible reason why our CBT for PD had little effect on improving social anxiety symptoms measured by the Brief Fear of Negative Evaluation Scale (BFNE) is that the SD of the BFNE score was too high because patients with PD had highly variable degrees of social anxiety symptoms

Summary

Introduction

In Japan, cognitive behavioral therapy (CBT) for panic disorder (PD) is not well established. A feasibility study of the clinical effectiveness and cost-effectiveness of CBT for PD in a Japanese clinical setting is urgently required. This was a pilot uncontrolled trial and the intervention consisted of a 16-week CBT program. Randomized controlled trials in Western countries have consistently indicated that individual CBT alone is effective for treating PD [11,12,13]. A feasibility study of individual CBT for PD in Japanese clinical settings is urgently required. A feasibility study would clarify whether CBT can achieve favorable treatment outcomes in Japanese PD patients, and whether it is sufficiently cost-effective

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