German Journal of Psychiatry    ISSN 1455-1033

2000, Vol. 3, Supplement 1, S8


Who is faster in overcoming anxiety? - Course and predictors of outcome of cognitive-behavioral therapy in inpatients with panic disorder

Gregor Peikert

Behavior Therapy Unit, Department of Psychiatry, Friedrich-Schiller-Universität Jena



OBJECTIVE: Both cognitive-behavioral therapy and antidepressants are effective in treatment of panic disorder, but up to now there is little known about differential efficacy of these therapies and about factors that accelerate or delay progress in therapy. 

METHODS: Eighty inpatients with severe panic disorders (94% with agoraphobia) were treated by cognitive-behavioral therapy (CBT), including cue exposure in vivo, during a period of 5 - 14 weeks. Fifty-one percent received additional pharmacological treatment, mainly SSRI or clomipramine. The Panic and Agoraphobia Scale (P&A, BANDELOW1) and several psychometric measures were administered weekly.

RESULTS: Better improvement was associated with higher phobic anxiety scores at the first examination, lower depression scores and the absence of personality disorders. Factors delaying therapeutic improvements were concomitant personality disorders, female sex, and a very high or very low education. The group treated with antidepressants did not show greater improvement or better outcome, but differed from the group free of medication regarding several features, for instance these patients had more affective disorders, higher general anxiety, or longer duration of illness. 

CONCLUSIONS: Several factors, such as concomitant personality disorders, influence the course of therapy in panic disorder inpatients. Additional medication in this study did not enhance the improvement during CBT, but the two treatment groups were primarily different in some aspects. 

1Bandelow, B., 1999. Panic and Agoraphobia Scale (PAS). Göttingen/Bern/Toronto/Seattle: Hogrefe & Huber Publishers