Internet cognitive–behavioural treatment for panic disorder: randomised controlled trial and evidence of effectiveness in primary care
Open accessAbstract
Background: Internet cognitive–behavioural therapy (iCBT) for panic disorder of up to 10 lessons is well established. The utility of briefer programmes is unknown. Aims: To determine the efficacy and effectiveness of a five-lesson iCBT programme for panic disorder. Method: Study 1 (efficacy): Randomised controlled trial comparing active iCBT (n=27) and waiting list control participants (n=36) on measures of panic severity and comorbid symptoms. Study 2 (effectiveness): 330 primary care patients completed the iCBT programme under the supervision of primary care practitioners. Results: iCBT was significantly more effective than waiting list control in reducing panic (g=0.97, 95% CI 0.34 to 1.61), distress (g=0.92, 95% CI 0.28 to 1.55), disability (g=0.81, 95% CI 0.19 to 1.44) and depression (g=0.79, 95% CI 0.17 to 1.41), and gains were maintained at 3 months post-treatment (iCBT group). iCBT remained effective in primary care, but lower completion rates were found (56.1% in study 2 v. 63% in study 1). Adherence appeared to be related to therapist contact. Conclusions: The five-lesson Panic Program has utility for treating panic disorder, which translates to primary care. Adherence may be enhanced with therapist contact.
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Within-group effect sizes for primary symptoms (Hedges g=1.38 for LSAS and 1.79 for PDSS) were as substantial as those observed in previous representative studies.
“Notably, the within-group effect sizes for the primary symptoms in this study (Hedges g=1.38 for LSAS and 1.79 for PDSS) were as substantial as those observed in previous representative studies [49-51].”
From Feasibility of Guided Internet-Based Cognitive Behavioral Therapy for Panic Disorder and Social Anxiety Disorder in Japan: Pilot Single-Arm Trial (2024) · cites this paper as [49]
Scoring ≥8 on the PDSS-SR suggests a likely panic disorder diagnosis.
“Scoring ≥8 suggests a likely panic disorder diagnosis. 40”
It is common practice to employ a cut-off score of 8 on the PDSS-SR.
“It is common practice to employ a cut-off score of 8 on the PDSS-SR [42-44], based on the cut-off initially established for the nonself-report PDSS [45].”
From Initial Outcomes of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy Tailored to Public Safety Personnel: Longitudinal Observational Study (2021) · cites this paper as [44]
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- Authors
- Allen, A. R., Newby, J. M., Mackenzie, A., Smith, J., Boulton, M., Loughnan, S. A., & Andrews, G.
- Affiliations
- UNSW Sydney (AU)
- Corresponding author
- Allen, Adrian R.
- Venue
- BJPsych Open
- Publisher
- Royal College of Psychiatrists
- Published
- 2016-03
- Volume
- 2
- Issue
- 2
- Pages
- 154-162
- ISSN
- 2056-4724 (ISSN-L)
- PMC
- PMC4998930
- OpenAlex
- W2309462332
- Cited by
- 43
- References
- 36
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 9 · 2020: 6 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 1
- FWCI
- 4.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BJPsych Open (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Funders
- Medical Research Council
- National Health and Medical Research Council (1037787)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- panic disorder, brief psychotherapy, primary care, treatment efficacy, treatment effectiveness, medication adherence, therapist contact, comorbid depression, program completion
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