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Efficacy of 2 interventions for panic disorder in patients presenting to the ED with chest pain.
MedLine Citation:
PMID:  20870368     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: Brief and efficacious interventions for panic disorder (PD) in patients presenting to emergency departments (EDs) for chest pain are essential. This study assessed the effects of 2 interventions for this population: a brief cognitive-behavioral therapy delivered by psychologists, and a 6-month pharmacologic treatment initiated and managed by the ED physician. The relative efficacy of both interventions was also examined.
MATERIALS AND METHODS: Forty-seven adult patients meeting the diagnostic criteria for PD upon presentation to the ED were assigned to 1 of 3 experimental conditions: a brief cognitive-behavioral therapy (7 sessions), a pharmacologic intervention (paroxetine; 6 months); and a usual care control condition. The primary outcome was severity of PD on Anxiety Disorder Interview Schedule for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and secondary outcomes included measures of PD symptoms, depressive symptoms, and cardiac anxiety. Outcome measures were taken at baseline, postintervention, as well as at 3- and 6-month follow-ups.
RESULTS: Patients receiving either intervention demonstrated significant reductions of PD severity (P = .012), frequency of panic attacks (P = .048), and depressive symptoms (P = .027).
CONCLUSION: Taken together, these findings suggest that empirically validated interventions for PD initiated in an ED setting can be feasible and efficacious, and future studies should assess their impact on both the direct (ie, health care utilization) and indirect (ie, lost productivity) costs associated with PD morbidity in this population.
Marie-Ève Pelland; André Marchand; Marie-Josée Lessard; Geneviève Belleville; Jean-Marc Chauny; Alain Vadeboncoeur; Julien Poitras; Guillaume Foldes-Busque; Simon L Bacon; Kim L Lavoie
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Publication Detail:
Type:  Journal Article     Date:  2010-09-25
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  29     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1051-61     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Department of Psychology, Université du Québec à Montréal, PO Box 8888, Downtown Station, Montreal, Quebec, Canada H3C 3P8.
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