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Internet-Delivered Psychological Treatment Options for Panic Disorder: A Review on Their Efficacy and Acceptability

Jennifer Apolinário-Hagen
대한신경정신의학회 (Korean Neuropsychiatric Association)|2019.01|PSYCHIATRY INVESTIGATION|제16권 제1호|pp. 37-49|DOI https://doi.org/10.30773/pi.2018.06.26

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키워드

Anxiety disorderPanic disorderCognitive behavior therapyeHealthInternet.
주제분류정신과학

초록

Background Internet-delivered psychological treatments have been suggested as a chance to expand the access to professional help. However, little is known about the usefulness of different support formats and approaches of digital treatments for panic disorder among clinicians. Objective This narrative review aimed to explore the recent evidence base on the efficacy and acceptability of different internet-delivered treatments for adults with panic disorder. Methods A systematic search in electronic databases (Pubmed/Medline, PSYNDEX) and a hand search were performed to identify articles on randomized controlled trials published within the past five years (2012/12/10–2017/12/12) in English peer-reviewed journals. Results Eight studies (1,013 participants) involving 10 interventions met the inclusion criteria. Nine interventions were primarly based on Cognitive Behavioral Therapy principles. Most interventions were effective, when compared to a control condition (6 of 8 comparisons). Minimal guidance was associated with improved outcomes in one study and adherence in two studies (3 comparisons). Furthermore, no differences were found based on treatment approach (2 comparisons). Regarding acceptability, the attrition rates were moderate to high, ranging from 9.8% to 42.1% of randomized participants. Adherence rates also varied largely (7.8–75%), whereas participant satisfaction of program completers was assessed overall high (5 studies). Conclusion Diverse effective internet-delivered treatments are available for the self-management of panic symptoms. Especially selfguided and transdiagnostic Cognitive Behavioral Therapy approaches appear being efficient options for the dissemination in routine care. However, due to the limited evidence base, further efforts are required to improve the actual uptake of internet-delivered treatments and identify moderators of outcomes.

Abstract

Background Internet-delivered psychological treatments have been suggested as a chance to expand the access to professional help. However, little is known about the usefulness of different support formats and approaches of digital treatments for panic disorder among clinicians. Objective This narrative review aimed to explore the recent evidence base on the efficacy and acceptability of different internet-delivered treatments for adults with panic disorder. Methods A systematic search in electronic databases (Pubmed/Medline, PSYNDEX) and a hand search were performed to identify articles on randomized controlled trials published within the past five years (2012/12/10–2017/12/12) in English peer-reviewed journals. Results Eight studies (1,013 participants) involving 10 interventions met the inclusion criteria. Nine interventions were primarly based on Cognitive Behavioral Therapy principles. Most interventions were effective, when compared to a control condition (6 of 8 comparisons). Minimal guidance was associated with improved outcomes in one study and adherence in two studies (3 comparisons). Furthermore, no differences were found based on treatment approach (2 comparisons). Regarding acceptability, the attrition rates were moderate to high, ranging from 9.8% to 42.1% of randomized participants. Adherence rates also varied largely (7.8–75%), whereas participant satisfaction of program completers was assessed overall high (5 studies). Conclusion Diverse effective internet-delivered treatments are available for the self-management of panic symptoms. Especially selfguided and transdiagnostic Cognitive Behavioral Therapy approaches appear being efficient options for the dissemination in routine care. However, due to the limited evidence base, further efforts are required to improve the actual uptake of internet-delivered treatments and identify moderators of outcomes.

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