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Table 2 Characteristics of the included studies

From: Combination of psychotherapy and benzodiazepines versus either therapy alone for panic disorder: a systematic review

Study

Participants

Acute phase interventions

Maintenance interventions

Follow-up

Definition of response

Other outcomes

Marks 1993 [20]

Diagnosis: DSM-III PD with AG

Mean duration: 8 years

Mean age: 35 years

81% female

Psychiatric comorbidity: 10% current MDD, 30% past MDD, 10% social phobia, 25% specific phobia

Physical comorbidity: unspecified

Duration: 16 weeks

Weeks 0–8: benzodiazepine (alprazolam [A]) or pill-placebo (P), with live exposure (E) or with relaxation (R) (R = psychological-placebo).

Weeks 9–16: A & P tapered to zero, no E or R given.

i.e. 4 groups: AR, AE, PR, PE

AR=bz alone

AE=bz+psychotherapy

PR=double placebo

PE=psychotherapy alone

1. Benzodiazepine mean dose 5.8 mg/day)

2. Psychotherapy or placebo = 2 hours live exposure or relaxation 6 sessions

None

Assessments "at the end of acute treatment" gathered at 2 weeks after actual treatment termination. Long-term follow-up at 7 months after treatment termination.

'Very much' or 'much' improved on Clinician's CGI. Numbers of responders calculated using normal curve [36]

Global severity of PD: 7-point CGI rated by assessors

Panic attack: total number of major panics per week

Agoraphobia: 4 phobic targets avoidance

General anxiety: 14-item HAM-A

Depression: 17-item HAM-D Social functioning: 9-point assessor-rated scale for work, social, and family adjustment

Wardle 1994 [41]

Diagnosis: ICD-9 and DSM-III-R AG

Mean duration: 11–12 years

Mean age: 41–45 years in each arm

82% female

Psychiatric co morbidity: Not specified

Excluded if had comorbid heart disease, alcohol problems, drug abuse, pregnancy or anticipated pregnancy, or major psychotic illness

Duration: 16 weeks

16 weeks for benzodiazepine (with drug taper) and 8 weeks for psychotherapy (week 4–12)

1. Diazepam (the dose was kept to 5 mg/day unless the patient requested an increase) + BT (eight 2-hour sessions over a 7 week period by a clinical psychologists). Medication was tapered to zero from week 13 to 16.

2. BT + placebo drug

None

At 1, 6, 12 months after treatment discontinuation

Patients were advised to continue self-exposure. After the acute treatment phase, all patients were withdrawn during 0–1 month after treatment discontinuation. No further treatment was offered over the follow-up period unless the patient's clinical condition necessitated intervention.

50% reduction on MAL from the baseline by looking at the raw data

Global severity of panic disorder: MAL

Panic attack: Panic frequency in past week

Agoraphobia: MAL

General anxiety: STAIS-T

Depression: BDI

Social functioning: Not applicable

  1. AG: agoraphobia; BDI: Beck Depression Inventory; BT: Behaviour therapy; CGI: Clinician's Global Improvement; HAM-A: Hamilton Anxiety Rating Scale; HAM-D: Hamilton Depression Rating Scale; MAL: Mobility Inventory 'Mobility Alone'; MDD: Major depressive disorder; MAL: Mobility index – Mobility alone; PD: panic disorder; STAIS-T: State-Trait Anxiety Inventory-Trait Anxiety