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Can J Psychiatry. 2013 Jun;58(6):326-34.

Implementing panic-focused psychodynamic psychotherapy into clinical practice.

Author information

  • 1Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Mainz, Germany. manfred.beutel@unimedizin-mainz.de

Abstract

in English, French

OBJECTIVE:

To determine the effectiveness of manualized panic-focused psychodynamic psychotherapy (PFPP) in routine care in Germany.

METHOD:

German psychoanalysts were trained according to the PFPP manual. Fifty-four consecutive outpatients with panic disorder (with or without agoraphobia) were randomly assigned in a 2:1 ratio to PFPP or cognitive-behavioural therapy (CBT) plus exposure therapy. Subjects (female 57.4%; mean age 36.2 years) had high rates of psychiatric (68.5%) and somatic (64.8%) comorbidity, and previous psychiatric treatments (57.4%). Assessments were performed pre- and posttreatment and at 6-month follow-up. The primary outcome measure was the Panic Disorder Severity Scale.

RESULTS:

Both treatments were highly effective. In patients randomized to PFPP, remission was achieved in 44.4% at termination and by 50% at follow-up (CBT 61.1% and 55.6%, respectively). No significant differences were found. Emotional awareness, a posited moderator of good outcome in psychotherapies, was significantly higher in the CBT group at baseline. It was found to be a strong moderator of treatment effectiveness in both treatments. After adjusting for initial Levels of Emotional Awareness Scale (LEAS) scores, effect sizes (ESs) for the primary outcome were Cohen d = 1.28, from pre- to posttreatment, and d = 1.03, from pretreatment to follow-up, for PFPP, and d = 1.81 and 1.28 for CBT, respectively.

CONCLUSIONS:

PFPP was implemented effectively into clinical practice by psychoanalysts in the community in a sample with severe mental illness with large ESs. Assessment of LEAS may facilitate the identification of patients suitable for short-term psychotherapy. (

CLINICAL TRIAL REGISTRATION NUMBER:

German Clinical Trials Register, DRKS00000245; Universal Trial Number, U1111-1112-4245).

KEYWORDS:

agoraphobia; cognitive-behavioural therapy; effectiveness; follow-up; panic disorder; panic-focused psychodynamic psychotherapy

PMID:
23768260
[PubMed - indexed for MEDLINE]
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