Applied relaxation, exposure in vivo and cognitive methods in the treatment of panic disorder with agoraphobia.

Forty-five psychiatric outpatients with DSM-III-R diagnosis of panic disorder with agoraphobia were assessed with a battery of self-report, behavioral and cognitive measures before and after therapy, and at a 1 yr follow-up. They were randomly assigned to either Applied Relaxation (AR; n = 15), Exposure in vivo (E; n = 15) or Cognitive Treatment (CT; n = 15) and received 12 individual therapy sessions, once weekly. All patients also had self-exposure instructions. The three treatments yielded significant improvements that were maintained at follow-up. One criterion of clinically significant improvement was fulfilled by 87% of the AR-, 80% of the E- and 60% of the CT-patients at the end of treatment, and 85, 79 and 67%, respectively, at follow-up. Between-group differences were observed on two measures only, both showing better results for AR than for CT. The conclusion that can be drawn is that the three treatments, focussed on different anxiety components, are about equally effective, and the results are maintained 1 yr after the end of treatment.