Long-term outcome for patients with panic disorder treated with cognitive-behavioral therapy.

Psychological approaches to panic disorder with agoraphobia have concentrated on agoraphobic avoidance behavior associated with panic attacks through use of exposure-based methods. These have proven reasonably successful but few patients are "cured," and a number continue to experience anxiety and panic. More recently, treatments with the goal of reducing panic attacks directly have been developed. These are based on a new psychobiological model of panic disorder that suggests some people are predisposed to panic, particularly when under stress. A minority develop anxiety about the possibility of another panic attack and become sensitive to sensations that signal an attack. The treatment developed at our center emphasizes systematic exposure to the somatic events associated with panic, breathing training, correcting misinformation about attacks, and the catastrophic cognitions associated with panic. Both initial and long-term outcome of early studies of this treatment are presented.