Abstract
BackgroundThe long-term prognosis after cognitive behavioral therapy (CBT) in outpatient groups for panic disorder and agoraphobia is not well known. The purpose of this study was to assess long-term outcomes in terms of psychological health, health-related quality of life (HRQoL), quality of life (QoL) and treatment satisfaction after CBT for panic disorder and agoraphobia.MethodsThe sample consisted of 68 patients (61% response rate), who were assessed at pretreatment; at the start and end of treatment; and after 3 months, after 1 year, and over the long term (M = 24 years; SD = 5.3; range: 12 to 31 years). The main outcome was the total score on the Phobic Avoidance Rating Scale (PARS-total). At long-term follow-up, HRQoL was measured with the RAND-12 questionnaire, and QoL was measured with two questions from the “Study on European Union Statistics on Income and Living Conditions”. Patient experiences and treatment satisfaction were assessed by the Generic Short Patient Experiences Questionnaire. A marginal longitudinal model was applied to study the main outcome.ResultsThe effect size of the long-term change (mean change/ pooled SD) in the PARS-total score was (− 1.6, p < 0.001) and was stable over time. A PARS-total score reduction of 50% was found in 98% of patients at the long-term follow-up. The patients’ HRQoL and QoL were similar to the expected scores for the general Norwegian population. Of the patients, 95% reported high to very high satisfaction with the CBT, and 93% reported large treatment benefits.ConclusionsTo the best of our knowledge, this study has the longest follow-up after group CBT for panic disorder and agoraphobia, showing a good prognosis in ≥93% of the participating patients.
Highlights
The long-term prognosis after cognitive behavioral therapy (CBT) in outpatient groups for panic disorder and agoraphobia is not well known
We found no long-term follow-up study of patients treated with group CBT in the general clinical setting
A reduction of 50% in the Phobic Avoidance Rating Scale (PARS)-total score was found in 82% of the patients by the end of treatment and in 98% of patients by the 24-year follow-up
Summary
The long-term prognosis after cognitive behavioral therapy (CBT) in outpatient groups for panic disorder and agoraphobia is not well known. The purpose of this study was to assess long-term outcomes in terms of psychological health, health-related quality of life (HRQoL), quality of life (QoL) and treatment satisfaction after CBT for panic disorder and agoraphobia. Some have found that good results can be achieved following group CBT [6], and this format may be more cost effective and feasible in the clinical setting. In two long-term studies with patients following inpatient treatment with emphasis of group therapy, 38 patients (71%) were assessed 20 years after a combination of exposure and psychodynamic therapy [13], while 31 (67%) were investigated after cognitive and guided mastery therapy [14]. The long-term outcomes were very good in both samples
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