Internet cognitive-behavioural treatment for panic disorder: randomised controlled trial and evidence of effectiveness in primary care

Background Internet cognitive-behavioural therapy (iCBT) for panic disorder of up to 10 lessons is well established. The utility of briefer programmes is unknown. Aims To determine the efficacy and effectiveness of a five-lesson iCBT programme for panic disorder. Method Study 1 (efficacy): Randomised controlled trial comparing active iCBT (n= 27) and waiting list control participants (n= 36) on measures of panic severity and comorbid symptoms. Study 2 (effectiveness): 330 primary care patients completed the iCBT programme under the supervision of primary care practitioners. Results iCBT was significantly more effective than waiting list control in reducing panic (g= 0.97, 95% CI 0.34 to 1.61), distress (g= 0.92, 95% CI 0.28 to 1.55), disability (g= 0.81, 95% CI 0.19 to 1.44) and depression (g= 0.79, 95% CI 0.17 to 1.41), and gains were maintained at 3 months post-treatment (iCBT group). iCBT remained effective in primary care, but lower completion rates were found (56.1% in study 2 v. 63% in study 1). Adherence appeared to be related to therapist contact. Conclusions The five-lesson Panic Program has utility for treating panic disorder, which translates to primary care. Adherence may be enhanced with therapist contact. Copyright and usage (C) The Royal College of Psychiatrists 2016.