cognitive-behavioral therapy,imipramine,or their combination for panic disorder a randomized controlled trial外文电子书.pdf

ORIGINAL CONTRIBUTION Cognitive-Behavioral Therapy, Imipramine, or Their Combination for Panic Disorder A Randomized Controlled Trial David H. Barlow, PhD Context Panic disorder (PD) may be treated with drugs, psychosocial intervention, or Jack M. Gorman, MD both, but the relative and combined efficacies have not been evaluated in an unbiased fashion. M. Katherine Shear, MD Objective To evaluate whether drug and psychosocial therapies for PD are each more Scott W. Woods, MD effective than placebo, whether one treatment is more effective than the other, and ANIC DISORDER (PD) IS A whether combined therapy is more effective than either therapy alone. chronic condition associated Design and Setting Randomized, double-blind, placebo-controlled clinical trial con- with substantial reduction in ducted in 4 anxiety research clinics from May 1991 to April 1998. P 1 and lifetime Patients A total of 312 patients with PD were included in the analysis. quality of life, prevalence rates are approximately Interventions Patients were randomly assigned to receive imipramine, up to 300 mg/d, 3%.2,3 Role functioning is substantially only (n=83); cognitive-behavioral therapy (CBT) only (n=77); placebo only (n=24); CBT lower in patients with PD than in plus imipramine (n=65); or CBT plus placebo (n=63). Patients were treated weekly for patients with diabetes, heart disease, or 3 months (acute phase); responders were then seen monthly for 6 months (mainte- arthritis.4 Individuals with PD fre- nance phase) and then followed up for 6 months after treatment discontinuation. quently use both emergency d