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Comparing physical exercise in groups to group cognitive behaviour therapy for the treatment of panic disorder in a randomized controlled trial.

Hovland A, Nordhus IH, Sjøbø T, Gjestad BA, Birknes B, Martinsen EW, Torsheim T, Pallesen S - Behav Cogn Psychother (2012)

Bottom Line: Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking.A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT.This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later.

View Article: PubMed Central - PubMed

Affiliation: University of Bergen, and Solli District Psychiatric Centre-DPS, Nesttun, Norway. anders.hovland@psykp.uib.no

ABSTRACT

Background: Previous studies have suggested that physical exercise can reduce symptoms for subjects suffering from panic disorder (PD). The efficacy of this intervention has so far not been compared to an established psychotherapy, such as cognitive behaviour therapy (CBT). Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking.

Aim: To compare physical exercise to CBT as treatment for PD, and assess controlled long-term and clinically significant effects.

Method: PD-patients were randomized to either three weekly sessions of physical exercise (n = 17), or one weekly session of CBT (n = 19). Both treatments ran for 12 weeks, were manualized and administered in groups. Patients were assessed twice before the start of treatment, at post-treatment and at 6 and 12 months thereafter. Primary outcome-measures consisted of the Mobility Inventory (MI), the Agoraphobia Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ).

Results: A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT. This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later.

Conclusion: Group CBT is more effective than group physical exercise as treatment of panic disorder, both immediately following treatment and at follow-up assessments.

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Related in: MedlinePlus

Consort diagram displaying the process of inclusion, allocation and attrition. PE = physical exercise a Includes subjects whose job, studies or distance of travel prevented participation.
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fig1: Consort diagram displaying the process of inclusion, allocation and attrition. PE = physical exercise a Includes subjects whose job, studies or distance of travel prevented participation.

Mentions: Of the 141 subjects who made contact with the study's staff, 66 were invited for a detailed diagnostic interview (see Figure 1 for an overview of participants’ flow in the study). The most frequent reasons for exclusion at this stage were either that the symptoms did not indicate the presence of PD, or that subjects declined participation when informed about the nature of the study. Of the 66 invited subjects, 36 participants were randomized to either of the two treatment conditions. Excluded subjects either failed to match inclusion and exclusion criteria, or declined to participate. A total of four participants (11% of the sample) were referred for a cardiac evaluation prior to treatment. Only one participant dropped out during the course of treatment (in the CBT-intervention following the second treatment session). Thus, 35 participants received treatment as planned. For various reasons, some participants did not complete the follow-up assessments (see Figure 1). At the 6-month follow-up, one participant from the physical exercise group declined assessment, while a total of four from the CBT group were not assessed. At the 12-month follow-up, a total of three participants in each condition were not assessed. Viewed together, only three participants were not assessed at either one of the follow-up assessments: one in the physical exercise-condition and two in the CBT-condition.Figure 1.


Comparing physical exercise in groups to group cognitive behaviour therapy for the treatment of panic disorder in a randomized controlled trial.

Hovland A, Nordhus IH, Sjøbø T, Gjestad BA, Birknes B, Martinsen EW, Torsheim T, Pallesen S - Behav Cogn Psychother (2012)

Consort diagram displaying the process of inclusion, allocation and attrition. PE = physical exercise a Includes subjects whose job, studies or distance of travel prevented participation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3675676&req=5

fig1: Consort diagram displaying the process of inclusion, allocation and attrition. PE = physical exercise a Includes subjects whose job, studies or distance of travel prevented participation.
Mentions: Of the 141 subjects who made contact with the study's staff, 66 were invited for a detailed diagnostic interview (see Figure 1 for an overview of participants’ flow in the study). The most frequent reasons for exclusion at this stage were either that the symptoms did not indicate the presence of PD, or that subjects declined participation when informed about the nature of the study. Of the 66 invited subjects, 36 participants were randomized to either of the two treatment conditions. Excluded subjects either failed to match inclusion and exclusion criteria, or declined to participate. A total of four participants (11% of the sample) were referred for a cardiac evaluation prior to treatment. Only one participant dropped out during the course of treatment (in the CBT-intervention following the second treatment session). Thus, 35 participants received treatment as planned. For various reasons, some participants did not complete the follow-up assessments (see Figure 1). At the 6-month follow-up, one participant from the physical exercise group declined assessment, while a total of four from the CBT group were not assessed. At the 12-month follow-up, a total of three participants in each condition were not assessed. Viewed together, only three participants were not assessed at either one of the follow-up assessments: one in the physical exercise-condition and two in the CBT-condition.Figure 1.

Bottom Line: Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking.A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT.This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later.

View Article: PubMed Central - PubMed

Affiliation: University of Bergen, and Solli District Psychiatric Centre-DPS, Nesttun, Norway. anders.hovland@psykp.uib.no

ABSTRACT

Background: Previous studies have suggested that physical exercise can reduce symptoms for subjects suffering from panic disorder (PD). The efficacy of this intervention has so far not been compared to an established psychotherapy, such as cognitive behaviour therapy (CBT). Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking.

Aim: To compare physical exercise to CBT as treatment for PD, and assess controlled long-term and clinically significant effects.

Method: PD-patients were randomized to either three weekly sessions of physical exercise (n = 17), or one weekly session of CBT (n = 19). Both treatments ran for 12 weeks, were manualized and administered in groups. Patients were assessed twice before the start of treatment, at post-treatment and at 6 and 12 months thereafter. Primary outcome-measures consisted of the Mobility Inventory (MI), the Agoraphobia Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ).

Results: A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT. This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later.

Conclusion: Group CBT is more effective than group physical exercise as treatment of panic disorder, both immediately following treatment and at follow-up assessments.

Show MeSH
Related in: MedlinePlus