Videoconference-delivered cognitive behavioral therapy in patients with symptomatic panic disorder following primary pharmacotherapy: a randomized, assessor-blinded, controlled trial.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Cognitive Behavioral Therapy*/methods ; Panic Disorder*/therapy ; Panic Disorder*/drug therapy ; Videoconferencing*; Humans ; Female ; Male ; Adult ; Middle Aged ; Treatment Outcome ; Telemedicine ; Severity of Illness Index

Competing Interests: Declarations. Ethics approval and consent to participate: The study received ethical approval from the Institutional Review Board of Chiba University Hospital (reference number: G29036). All procedures performed in this study comply with the ethical standards of the relevant national and institutional committees on human experimentation and the Helsinki Declaration. The study was also registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029987; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi? recptno=R000034247) on Nov 20, 2017. Written informed consent was obtained from all patients after they were fully briefed on the procedures prior to screening for eligibility. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
Background: Additional treatment options for pharmacotherapy-refractive patients with panic disorder are needed. Given the difficulty in accessing professional cognitive behavioral therapy in real-world clinical settings, pharmacotherapy remains the typical treatment in patients with panic disorder. However, some patients with panic disorder remain symptomatic despite pharmacotherapy. In this study, to highlight next-step treatment options for patients with panic disorder, we aimed to assess the efficacy of videoconference-based cognitive behavioral therapy for patients with panic disorder who remained symptomatic despite initial pharmacological treatment. To this end, we evaluated the effectiveness of videoconference-based cognitive behavioral therapy for patients as an adjunct to usual care.
Methods: Symptomatic patients with panic disorder following primary pharmacotherapy were randomly assigned to videoconference-based cognitive behavioral therapy or usual care-only groups. The primary outcomes were a reduction in symptomatology assessed at 8 and 16 weeks, using the Panic Disorder Severity Scale. We calculated the 95% confidence intervals (CIs) of the mean with an unknown variance.
Results: Thirty participants were included in this study. After 16 weeks, the adjusted mean changes in Panic Disorder Severity Scale score from baseline were - 7.92 and 0.75 in the videoconference-based cognitive behavioral therapy (n = 15) and usual care (n = 15) groups, respectively, with a between-group difference of - 8.67 (95% CI: -11.80 to - 5.54; P < .0001). A considerable proportion of patients in the videoconference-based cognitive behavioral therapy group achieved a positive response at week 16 (80% vs. 6.7%; P < .001) and demonstrated a higher remission rate (66.7% vs. 0.0%; P < .001) than that in the usual care group.
Conclusions: Thus, videoconference-based cognitive behavioral therapy is an effective treatment for patients with panic disorder who remain symptomatic following pharmacotherapy. The results suggest that videoconference-based cognitive behavioral therapy, which can be used at home, may be effective for patients with panic disorder or chronic panic disorder who have difficulty accessing cognitive behavioral therapy.
Trial Registration: The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029987) on Nov 20, 2017.
(© 2025. The Author(s).)

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16K08863 Japan Society for the Promotion of Science

Keywords: Antidepressive agent; Anxiolytics; Cognitive behavioral therapy; Panic disorder; Randomized controlled trial; Videoconference

Date Created: 20250924 Date Completed: 20250925 Latest Revision: 20250927

20250927

PMC12462340

10.1186/s12888-025-07320-2

40993573