Internet-based Self-help Treatment for Panic Disorder: Two Ways of Complementary Psychological Support
Condition: Panic Disorder
MeSH terms: Panic Disorder
Study type: Interventional

Summary: 
      The aim of this study was to compare two ways of administrating the complementary
      psychological support (scheduled vs. non-scheduled) in an online self-help program for panic
      disorder. In order to do so, the investigators studied: a) If there were differences in the
      intensity and frequency of the symptoms of panic disorder. b) If there were differences in
      the therapeutic adherence between the subjects receiving both kinds of complementary support.
      c) If the more time spent by a psychologist in therapeutic interventions produced the best
      results of therapeutic adherence / symptom improvement.

      Seventy seven subjects followed the online self-help program for 8 weeks; 27 subjects had the
      support of a therapist via phone when they required it, 25 subjects had the support of a
      therapist weekly and 25 subjects were in the waiting list as a control group.
    

Detailed description: 
      The aim of this study was to compare two ways of administrating the complementary
      psychological support (scheduled vs. non-scheduled) in an online self-help program for panic
      disorder. In order to do so, the investigators studied: a) If there were differences in the
      intensity and frequency of the symptoms of panic disorder. b) If there were differences in
      the therapeutic adherence between the subjects receiving both kinds of complementary support.
      c) If the more time spent by a psychologist in therapeutic interventions produced the best
      results of therapeutic adherence / symptom improvement.

      Treatment program

      Internet-based self-help program for anxiety disorders "FREE OF ANXIETY" was developed, based
      on cognitive behavioral therapy. The program is presented as an interactive course, which is
      divided into eight weekly modules.A number of therapeutic components are used: psychological
      education (modules 1-8), behavioral analysis (safety and avoidance behavior) (module 2), in
      vivo and interoceptive exposure (modules 2-8), relaxation training and diaphragmatic
      breathing (modules 1-4), cognitive restructuring (modules 4-5), mindfulness (Module 6)
      communication training (module 7), problem solving Module 8). The program also includes a
      messaging system between therapists and subjects.

      Participants and Procedure

      The participants were recruited using a google banner linked to searches about anxiety
      disorders. The individuals were redirected to a Web page which contained information about
      anxiety disorders and the aims of the study. Suicide risk (score of 3 in the 15th item of the
      Web Screening Questionnaire) was established as an exclusion criterion. The study was
      approved by the ethics committee of the Autonomous University of Barcelona.

      Applicants completed the informed consent, the demographic questionnaire and a screening
      questionnaire online. One week later a psychologist who had been trained to apply the MINI
      International Neuropsychiatric Interview (Sheehan, Lecrubier, Harnett-Sheehan,
      Janavs,Weiller, Bonora, et al., 1997) assessed the presence of a current psychiatric
      diagnosis. Participants with Panic Disorder completed a battery of self-reported measures in
      order to assess panic disorder, anxiety, and depression symptoms.

      After clinical evaluation, the participants were divided into three groups by a true
      random-number service.

      The data collected were anonymized and coded

      Seventy seven subjects followed the online self-help program for 8 weeks; 27 subjects had the
      support of a therapist via phone when they required it, 25 subjects had the support of a
      therapist weekly and 25 subjects were in the waiting list as a control group.

      Participants completed self-reported measures at the end of the treatment, and six months
      later.

      Statistical analyses

      The investigators studied differences between participants with and without Panic Disorder
      regarding their gender and age, using Chi-square test and Student t-test.

      The participants' pretreatment and posttreatment measures were analyzed with analysis of
      variance (ANOVA) with repeated measures. These were followed by t tests with
      Bonferroni-corrected p values. Effect sizes were calculated both within and between groups,
      and all calculations were based on the pooled standard deviation, Cohen's d.

      All analyses were conducted using SPSS version 22 for Windows.
    

Intervention name(s): Scheduled support; Non-scheduled support
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants followed the online self-help program based on cognitive behavioral therapy for 8 weeks. They had the support of a therapist via phone weekly.; Participants followed the online self-help program based on cognitive behavioral therapy for 8 weeks. They had the support of a therapist via phone when they required it.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment