To make a run for IT - A feasibility study of ICBT combined with physical exercise for patients with panic disorder

Henning Johansen; Jon Vøllestad; Trond Sjøbø; Inger Hilde Nordhus; Ståle Pallesen; Odd E Havik; Egil W Martinsen; Tine Nordgreen; Anders Hovland

doi:10.1016/j.psychres.2020.113381

To make a run for IT - A feasibility study of ICBT combined with physical exercise for patients with panic disorder

Psychiatry Res. 2020 Nov:293:113381. doi: 10.1016/j.psychres.2020.113381. Epub 2020 Aug 18.

Authors

Henning Johansen¹, Jon Vøllestad², Trond Sjøbø³, Inger Hilde Nordhus⁴, Ståle Pallesen⁵, Odd E Havik⁶, Egil W Martinsen⁷, Tine Nordgreen⁸, Anders Hovland⁹

Affiliations

¹ Solli District Psychiatric Centre (DPS), Nesttun, Norway. Electronic address: johansenhenning@hotmail.com.
² Solli District Psychiatric Centre (DPS), Nesttun, Norway; Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
³ Solli District Psychiatric Centre (DPS), Nesttun, Norway.
⁴ Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway; Department of Behavioural Medicine, University of Oslo, Oslo, Norway.
⁵ Department of Psychosocial Science, University of Bergen, Norway og Optentia, the Vaal Triangle Campus of the North-West University, Vanderbijlpark, South-Africa.
⁶ Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway; Anxiety Disorders Research Network, Haukeland University Hospital, Bergen, Norway.
⁷ Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychosocial Science, University of Bergen, Bergen, Norway; Anxiety Disorders Research Network, Haukeland University Hospital, Bergen, Norway.
⁸ Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway; Bjørgvin District Psychiatric Centre (DPS), Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
⁹ Solli District Psychiatric Centre (DPS), Nesttun, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Bergen, Norway.

PMID: 32911348
DOI: 10.1016/j.psychres.2020.113381

Abstract

Background: Guided Internet-based cognitive behavioural therapy (ICBT) is a recommended treatment for panic disorder promising to increase treatment availability, but there are some concerns regarding adherence, including adherence to the in vivo exposure given as home assignments. The aim of this study was to assess the feasibility of combining ICBT with physical exercise with the aim of improving adherence and treatment response to ICBT.

Method: 12 participants were included via routine clinical practice to an open pre- post trial of feasibility using ICBT and an aerobe exercise protocol. We used a mixed model design investigating multiple areas of adherence, participants' experience and clinical outcome.

Results: 90.9% of the participants was considered completers in the ICBT program and the average adherence to the physical exercise was 93.1%. The experience of participating was summarized as "Hard work but worth it". Clinical outcomes effect sizes (d) ranged from 2.79 (panic severity) to .64 (Beck's anxiety index).

Conclusion: The sum results on adherence, qualitative and quantitative data all suggest that augmenting ICBT with an aerobic exercise protocol is feasible. We conclude that further research is warranted.

Keywords: Anxiety; Feasibility; HIIT; Internet-based CBT; Panic disorder; Physical exercise; Running.

MeSH terms

Adult
Cognitive Behavioral Therapy / methods*
Combined Modality Therapy / methods
Combined Modality Therapy / psychology
Exercise / physiology
Exercise / psychology
Feasibility Studies
Female
Humans
Male
Middle Aged
Panic Disorder / psychology*
Panic Disorder / therapy*
Running / physiology*
Running / psychology*
Therapy, Computer-Assisted / methods*
Treatment Outcome
Young Adult