Does maintenance CBT contribute to long-term treatment response of panic disorder with or without agoraphobia? A randomized controlled clinical trial
Open accessAbstract
OBJECTIVE: We examined the possibility that maintenance cognitive behavior therapy (M-CBT) may improve the likelihood of sustained improvement and reduced relapse in a multi-site randomized controlled clinical trial of patients who met criteria for panic disorder with or without agoraphobia. METHOD: Participants were all patients (N = 379) who first began an open trial of acute-phase CBT. Patients completing and responding to acute-phase treatment were randomized to receive either 9 monthly sessions of M-CBT (n = 79) or assessment only (n = 78) and were then followed for an additional 12 months without treatment. RESULTS: M-CBT produced significantly lower relapse rates (5.2%) and reduced work and social impairment compared to the assessment only condition (18.4%) at a 21-month follow-up. Multivariate Cox proportional hazards models showed that residual symptoms of agoraphobia at the end of acute-phase treatment were independently predictive of time to relapse during 21-month follow-up (hazards ratio = 1.15, p < .01). CONCLUSIONS: M-CBT aimed at reinforcing acute treatment gains to prevent relapse and offset disorder recurrence may improve long-term outcome for panic disorder with and without agoraphobia.
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A recent study observed symptom reduction in previous nonresponders beyond maintenance of improvements.
“Indeed, beyond maintenance of improvements, they also observed symptom reduction in previous nonresponders.”
From Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial. (2015) · cites this paper as [8]
The Results section (page unavailable) reports reduced panic-disorder symptom scores over time in the study sample, beyond its finding that maintenance CBT reduced relapse. But the Procedure section specifies that this sample comprised acute-treatment responders; nonresponders were assigned to separate trial arms. The paper therefore does not establish symptom reduction in previous nonresponders. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn patients with remitted anxiety disorders, M-CBT compared with assessment only was associated with lower relapse rates (5.2% vs 18.4%) at 21-month follow-up.
“Patients in the M-CBT group had significantly lower relapse rates (5.2%) compared to those in the assessment-only group (18.4%) at 21-month follow-up.”
From Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis (2022) · cites this paper as [56]
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- Authors
- White, K. S., Payne, L. A., Gorman, J. M., Shear, M. K., Woods, S. W., Saksa, J. R., & Barlow, D. H.
- Affiliations
- University of Missouri–St. Louis (US)
- University of California, Los Angeles (US)
- Columbia University (US)
- Yale University (US)
- Boston University (US)
- ORCID
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2013-02
- Volume
- 81
- Issue
- 1
- Pages
- 47-57
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3565038
- OpenAlex
- W2060891508
- Cited by
- 42
- References
- 49
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 5 · 2016: 3 · 2015: 7 · 2014: 3 · 2013: 4
- FWCI
- 6.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01 MH45963; MH45964; MH45965; MH45966)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- panic disorder, agoraphobia, relapse prevention, long-term treatment outcomes, residual symptoms, treatment response
- MeSH terms
- Adult, Agoraphobia, Female, Humans, Male, Middle Aged, Patient Compliance, Predictive Value of Tests, Psychiatric Status Rating Scales, Social Adjustment, Cognitive Behavioral Therapy, Proportional Hazards Models, Panic Disorder, Treatment Outcome, Secondary Prevention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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