Cognitive Behavioral Therapy vs. Eye Movement Desensitization and Reprocessing for Treating Panic Disorder: A Randomized Controlled Trial.

Jill Lobbestael,Brenda Den Oudsten,Ferdinand Horst,Ad De Jongh,Jolanda De Vries,Wobbe Zijlstra

doi:10.3389/fpsyg.2017.01409

Abstract

Objective: Cognitive Behavioral Therapy (CBT) is an effective intervention for patients with panic disorder (PD). From a theoretical perspective, Eye Movement Desensitization and Reprocessing (EMDR) therapy could also be useful in the treatment of PD because: (1) panic attacks can be experienced as life threatening; (2) panic memories specific to PD resemble traumatic memories as seen in posttraumatic stress disorder (PTSD); and (3) PD often develops following a distressing life event. The primary objective of this Randomized Controlled Trial (RCT), was to compare EMDR therapy with CBT for PD and determine whether EMDR is not worse than CBT in reducing panic symptoms and improving Quality Of Life (QOL).Methods: Two-arm (CBT and EMDR) parallel RCT in patients with PD (N = 84). Patients were measured at baseline (T1), directly after the last therapy session (T2), and 3 months after ending therapy (T3). Non-inferiority testing (linear mixed model with intention-to-treat analysis) was applied. Patients were randomly assigned to 13 weekly 60-min sessions of CBT (N = 42) or EMDR therapy (N = 42). Standard protocols were used. The primary outcome measure was severity of PD at T3, as measured with the Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ), and the Mobility Inventory (MI). The secondary outcome measure was QOL, as measured with the World Health Organization Quality of Life short version (WHOQOL-Bref), at T3.Results: The severity of PD variables ACQ and BSQ showed non-inferiority of EMDR to CBT, while MI was inconclusive (adjusted analyses). Overall QOL and general health, Psychological health, Social relationships, and Environment showed non-inferiority of EMDR to CBT, while Physical health was inconclusive.Conclusion: EMDR therapy proved to be as effective as CBT for treating PD patients.Trial Registration: Dutch Trial Register, Nr. 3134 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3134

Highlights

Panic disorder (PD) is characterized by recurrent, unexpected panic attacks and hyperarousal symptoms such as palpitations, pounding heart, chest pain, sweating, trembling, or shaking (Frances, 2004)
Patients were randomly assigned to 13 weekly 60-min sessions of Cognitive Behavioral Therapy (CBT) (N = 42) or Eye Movement Desensitization and Reprocessing (EMDR) therapy (N = 42)
EMDR therapy proved to be as effective as CBT for treating PD patients

Summary

Introduction

Panic disorder (PD) is characterized by recurrent, unexpected panic attacks and hyperarousal symptoms such as palpitations, pounding heart, chest pain, sweating, trembling, or shaking (Frances, 2004). These symptoms are often experienced as catastrophic and can have a great impact on daily life (Frances, 2004). Prevalence rates of PD are around 2.1% (Batelaan et al, 2006). Widowed, lower educated, and divorced persons are more likely to experience panic attacks (Batelaan et al, 2006)

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Conclusion