Source: DGNews  |  Posted 8 years ago

By Paula Moyer

SAN FRANCISCO, CA -- May 26, 2003 -- A new treatment strategy utilizing virtual reality and cognitive behavior therapy to treat panic disorder with agoraphobia achieves results similar to those seen with conventional treatment, but in one third the number of sessions.

"This treatment, known as experiential cognitive therapy, is as effective as conventional treatment," said Young-Hee Choi, MD, PhD, associate professor of psychiatry at Inje University in Seoul, South Korea. "Conventional treatment consists of 12 sessions, while experiential cognitive therapy consists of 4 sessions." He presented his findings here at the 156th Annual Meeting of the American Psychiatric Association.

Dr. Choi developed experiential cognitive therapy as a way to integrate cognitive-behavior therapy with virtual reality exposure to treat panic disorder with concomitant agoraphobia. Virtual reality is accomplished through a head-worn monitor in which the scenes that induce the phobic response are simulated, such as scenes of crowds, an airplane cabin, and an airplane taking off. Dr. Choi conducted this study to compare the efficacy of experiential cognitive therapy with that of conventional therapy for this disorder, known as panic control program (PCP).

He recruited 40 patients who had been diagnosed with panic disorder with agoraphobia by the diagnostic criteria of the Diagnostic and Statistical Manual-IV (DSM-IV). The patients were randomly assigned to experiential cognitive therapy or to the control group, which received the panic control program. Each group consisted of 20 patients. The groups were similar demographically.

Dr. Choi measured the treatment efficacy with the Beck Depression Inventory (BDI), the Spielberg State Anxiety Inventory (STAI-state), the Anxiety Sensitivity Index (ASI), the Panic Belief Questionnaire (PBQ), the Body Sensation Questionnaire (BSQ), and the Agoraphobic Cognition Questionnaire (ACQ). He also assessed the patients' panic attack frequency, the clinical severity rating (CSR), and the end-state function (ES), as well as patients' success rate in being able to discontinue or reduce their anti-anxiety medication after treatment and at 6-month follow-up.

On all criteria, the 2 groups showed significant improvement after treatment compared with their baseline scores. Dr. Choi documented no significant differences between the 2 groups, either immediately after or at the 6-month follow-up assessment. These findings led him to conclude that the 4 sessions of experiential cognitive therapy were similarly efficacious to the 12 sessions of traditional treatment.

"This study might be the first pilot study to apply short-term cognitive-behavior therapy, in combination with virtual reality exposure, to the treatment of panic disorder with agoraphobia," Dr. Choi said. "I recommend this therapy for patients who have this combination of symptoms."

[Study title: The Development And The Effects Of Experiential Cognitive Therapy For The Treatment Of Panic Disorder With Agoraphobia. Abstract NR813]