Geraldine O'Sullivan

Telephone-guided treatment for housebound agoraphobics with panic disorder: Exposure vs. relaxation

Thirty seven agoraphobics with panic disorder diagnosed in a telephone interview said they could not attend hospital for treatment. Of these, 23 agreed to self-treatment guided by phone and were randomized to exposure (n=13) or to relaxation (n=10), using self-instruction materials at home. Phobias and social adjustment improved significantly more in the 6 self-exposure cases who reached follow-up 32 weeks after trial entry than in the 8 comparable self-relaxation cases, who were more compliant yet did not improve significantly. Agoraphobics who say they cannot attend a clinic may be unusually severe and unmotivated cases, but telephone-guided exposure can help some of them.

Pre-treatment predictors of treatment outcome in panic disorder and agoraphobia treated with alprazolam and exposure

Pre-treatment predictors of treatment outcome were examined in a group of 144 patients with panic disorder and agoraphobia randomly allocated to alprazolam+exposure (AE), placebo+exposure (PE), alprazolam+relaxation (AR), and placebo+relaxation (PR). First-time psychotropic medication use, severity of agoraphobic disability, and longer duration of illness predicted less global improvement at post-treatment. Pre-treatment severity of agoraphobia predicted less improvement both in the short- and the long-term. Predictors of poorer outcome at 6-month follow-up were older age, past history of depression, severity of phobia targets, and longer duration of illness. Sex, source of referral, pre-treatment depression-anxiety-panic, and expectancy from treatment did not relate to outcome.