CBT-Intervention for panic disorder in primary care: 5 years follow-up of a cRCT during the Covid-19 pandemic

PLoS One. 2023 Jun 30;18(6):e0287718. doi: 10.1371/journal.pone.0287718. eCollection 2023.

Abstract

A practice team-based exercise programme with elements of cognitive behavioural therapy (CBT) and case management for patients with panic disorder with or without agoraphobia in primary care showed significant positive effects. Here, we analyse the long-term effects (>5 years) of this intervention in the stressful context of the Covid-19 pandemic. All participants of the original PARADIES cluster randomized controlled trial (cRCT; 2012-2016) were invited to participate in a follow-up during the Covid-19 pandemic. Clinical outcomes were anxiety symptoms, number and severity of panic attacks, agoraphobic avoidance behaviour, Covid-specific anxiety symptom severity, depression, and patient assessment of chronic illness care. Data were analysed cross-sectionally for group differences (intervention, control) and longitudinally (T0: baseline, T1: 6 months and TCorona: >60 months). Of the original 419 participants, 100 participated in the 60 months follow-up (October 2020-May 2021). In the cross-sectional analysis, the anxiety symptom severity in the intervention group was lower than in the control group (p = .011, Cohen's d = .517). In the longitudinal analysis, both groups showed an increase of anxiety and depression symptoms compared to pre-pandemic level. The intervention may have had a lasting impact regarding anxiety severity despite the challenging context of the Covid-19 pandemic. However, we cannot say to what extend the intervention still played a role in participants' lives; other factors may also have helped with coping. The increase of anxiety and depression symptoms in both groups over time could be attributed to external circumstances.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19*
  • Cognitive Behavioral Therapy*
  • Cross-Sectional Studies
  • Follow-Up Studies
  • Humans
  • Pandemics
  • Panic Disorder* / therapy
  • Primary Health Care

Grants and funding

The PARADIES-study and JG were funded by the Federal Ministry of Education and research (Bundesminis-terium für Bildung und Forschung, BMBF) (Grant-No. BMBF 01GY1146). CH received funding from the German Research Foundation (DFG - GrK 2621 / POKAL-Kolleg). The funders had no role in the study design, the collection, analysis and interpretation of data, the writing of the report or the decision to submit the article for publication.