Is a combined therapy more effective than either CBT or SSRI alone? Results of a multicenter trial on panic disorder with or without agoraphobia
Open accessAbstract
Objective: To establish whether the combination of cognitive‐behavioral therapy (CBT) and pharmacotherapy (SSRI) was more effective in treating panic disorder (PD) than either CBT or SSRI alone, and to evaluate any differential effects between the mono‐treatments. Method: Patients with PD ( n = 150) with or without agoraphobia received CBT, SSRI or CBT + SSRI. Outcome was assessed after 9 months, before medication taper. Results: CBT + SSRI was clearly superior to CBT in both completer and intent‐to‐treat analysis (ITT). Completer analysis revealed superiority of CBT + SSRI over SSRI on three measures and no differences between CBT and SSRI. ITT analysis revealed superiority of SSRI over CBT on four measures and no differences between CBT + SSRI and SSRI. Conclusion: Both the mono‐treatments (CBT and SSRI) and the combined treatment (CBT + SSRI) proved to be effective treatments for PD. At post‐test, CBT + SSRI was clearly superior to CBT, but differences between CBT + SSRI and SSRI, and between SSRI and CBT, were small.
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In clinical settings, approximately 20-40% of patients with panic disorder did not achieve full remission with recommended drugs or cognitive behavioral therapy.
“in clinical settings, approximately 20–40% of patients did not achieve full remission with the recommended drugs or CBT [10–12]”
From Management of Treatment-Resistant Panic Disorder (2017) · cites this paper as [12]
The Assessment and Treatment effects sections report panic-free and responder outcomes after CBT or SSRI, so the paper supports that not all treated patients reached those outcomes. It does not report a 20–40% failure-to-achieve-full-remission rate. The similar percentages in Attrition (22.9% for SSRI and 39.6% for CBT) are dropout rates, not remission rates; page numbers were unavailable in our copy. (LLM, conf=0.78)
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- Authors
- Van Apeldoorn, F. J., Van Hout, W. J. P. J., Mersch, P. P. A., Huisman, M., Slaap, B. R., Hale, W. W., Visser, S., Van Dyck, R., & Den Boer, J. A.
- Affiliations
- University Medical Center Groningen (NL)
- University of Groningen (NL)
- Organon (Netherlands) (NL)
- Utrecht University (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Venue
- Acta Psychiatrica Scandinavica
- Publisher
- Wiley
- Published
- 2008-02-26
- Volume
- 117
- Issue
- 4
- Pages
- 260-270
- ISSN
- 0001-690X (ISSN-L)
- 1600-0447
- OpenAlex
- W2117146356
- Cited by
- 65
- References
- 40
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 6 · 2015: 8 · 2014: 6 · 2013: 6 · 2012: 6
- FWCI
- 6.82
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Acta Psychiatrica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Rijksuniversiteit Groningen
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- panic disorder, agoraphobia, cognitive behavioral therapy, selective serotonin reuptake inhibitors, combined psychotherapy and pharmacotherapy, treatment efficacy, psychotherapy versus pharmacotherapy
- MeSH terms
- Adolescent, Adult, Agoraphobia, Anxiety Disorders, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Severity of Illness Index, Cognitive Behavioral Therapy, Panic Disorder, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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