Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: a comparison with younger patients.

Background: Older adults with panic disorder and agoraphobia (PDA) are underdiagnosed and undertreated, while studies of cognitive-behavioral therapy (CBT) are lacking. This study compares the effectiveness of CBT for PDA in younger and older adults.

Methods: A total of 172 patients with PDA (DSM-IV) received manualized CBT.

[Treatment of anxiety disorders in the elderly].

Aim: To collect empirical evidence concerning the effectiveness of the treatment of anxiety disorders in the elderly.

Method: Meta-analysis and randomised controlled trials.

Results: Meta-analysis showed that cognitive behavioural therapy (CBT) was more successful than waiting-list control or active control as a treatment for older persons with anxiety disorders.

Predictors of outcome of pharmacological and psychological treatment of late-life panic disorder with agoraphobia.

Objective: This study aims to evaluate the differential predictive values of age, age of onset and duration of illness on paroxetine and cognitive-behavioural therapy (CBT) outcome in late-life panic disorder with agoraphobia.

Method: Patients 60 years and older with a confirmed diagnosis of panic disorder with agoraphobia (n = 49) were randomly assigned to paroxetine (40 mg/day) treatment, individual CBT or a waiting-list control condition. Multiple regression analyses were conducted per treatment arm with post-treatment avoidance behaviour and agoraphobic cognitions as the dependent variables.

Agoraphobic cognitions in old and young patients with panic disorder.

Objectives: To compare the agoraphobic cognitions of younger and older patients suffering from panic disorder with agoraphobia by means of existing questionnaires.

Method: Agoraphobic cognitions were assessed using the Agoraphobic Cognitions Questionnaire (ACQ) in 205 patients confirmed with confirmed panic disorder with agoraphobia (Diagnostic and Statistical Manual, Fourth Edition, Text Revision) and analyzed at the item level applying a Bonferroni correction.

Results: The 48 patients who were older than 60 years had a significantly lower mean (SD) ACQ total score than their younger counterparts (1.

A randomized controlled study of paroxetine and cognitive-behavioural therapy for late-life panic disorder.

Objective: To examine the effectiveness of paroxetine and cognitive-behavioural therapy (CBT) in elderly patients suffering from panic disorder with or without agoraphobia (PD(A)).

Method: Forty-nine patients aged 60+ years with confirmed PD(A) were randomly assigned to 40 mg paroxetine, individual CBT, or to a 14-week waiting list. Outcomes, with avoidance behaviour and agoraphobic cognitions being the primary measures, were assessed at baseline and at weeks 8, 14 (conclusion CBT/waiting list), and at week 26 (treated patients only) and analysed using mixed models.

A transdiagnostic comparison of trauma and panic memories in PTSD, panic disorder, and healthy controls.

Inadequate processing of trauma information is considered to lead to particularly vivid recollections and disorganized memories of the trauma. Although trauma memories have mainly been investigated in PTSD, memories in other psychiatric disorders may actually share some characteristics. This may particularly be true for patients with panic disorder with agoraphobia (PDA) as a first panic attack resembles trauma.

[Treatment of obsessive-compulsive disorder in older patients - case studies].

Five patients aged 64 to 74 years with obsessive-compulsive disorder were treated successfully, one with cognitive behavioural therapy and four with a combination of antidepressants and cognitive behavioural therapy. The current multidisciplinary guidelines on anxiety treatment, which cover the age-range 18 to 65 years, are a good starting point for the treatment of obsessive compulsive disorder in older patients.

Cognitive-behavioural therapy for late-life anxiety disorders: a systematic review and meta-analysis.

Objective: To examine and estimate the efficacy of cognitive-behavioural therapy (CBT) for late-life anxiety disorders.

Method: A systematic review and meta-analysis of randomized controlled trials comparing CBT with i) a waiting-list control condition and ii) an active control condition controlling for non-specific effects in patients aged over 60 years and suffering from an anxiety disorder. The main outcome parameter of individual studies, i.

Habituation of premonitory sensations during exposure and response prevention treatment in Tourette's syndrome.

Exposure to premonitory sensations and response prevention of tics (ER) has been shown to be a promising new treatment for Tourette's syndrome (TS). The present study tested the hypothesis that habituation to unpleasant premonitory sensations associated with the tic is an underlying mechanism of change in ER. Patients rated the severity of sensations and urges at 15-minute intervals during ten 2-hour ER sessions.

Tic suppression in the treatment of Tourette's syndrome with exposure therapy: the rebound phenomenon reconsidered.

Exposure and response prevention (ER), a behavioral treatment program consisting of exposure to premonitory sensory experiences during prolonged tic suppression, was shown to be a promising new treatment for tics in Tourette's syndrome (TS). In this study, the commonly reported paradoxical increase in tic frequency following voluntary tic suppression, i.e.

Prevention of depression in subclinically depressed adults: follow-up effects on the 'Coping with Depression' course.

Background: People with subclinical depressive symptoms are at increased risk of depressive disorder, little is known on the prevention of depressive disorder in this population. This study evaluates the long-term preventive effects of an effective depression treatment, the Coping with Depression (CWD) course. This paper describes the effect of the CWD course on the incidence of depressive episodes and depressive symptoms, and explores whether the initial level of symptoms and gender has differential intervention effects.

Behavioural treatment of trichotillomania: two-year follow-up results.

Post-treatment evaluation studies of behaviour therapy (BT) for trichotillomania (TTM) have shown that BT is successful in reducing symptoms in this impulse-control disorder. The present study was aimed at investigating gain maintenance at long-term follow-up. TTM-related symptoms and other symptom characteristics were evaluated in 28 patients suffering from TTM before and after brief BT and at a 3-month and 2-year follow-up.

Exposure with response prevention versus habit reversal in Tourettes's syndrome: a controlled study.

The intentional nature of tics provides the opportunity to apply behavioural interventions aimed at tic reduction through interruption of stimulus-response sequences. The aim of this study has been to evaluate the effect of exposure and response prevention (ER) versus habit reversal (HR) in 43 Tourette's syndrome (TS) patients. The three outcome measures were: the Yale Global Tic Severity Scale (YGTSS), 15-min tic frequency registrations monitored at the institute and 15-min home tic frequency registrations.

Endogenous and exogenous attention in patients with conversion paresis.

Endogenous and exogenous attention of patients with conversion paresis was investigated using Posner's 'covert orienting of visual attention' task. In the light of previous evidence showing that inhibition of higher-level control functions plays a role in conversion paralysis (e.g.

Prophylactic efficacy of lithium versus carbamazepine in treatment-naive bipolar patients.

Background: Alternatives to lithium for prophylactic treatment of patients with bipolar affective disorders are increasingly being advocated. However, trials comparing lithium with alternatives are scarce and often biased.

Method: We studied 94 patients with at least 2 episodes of bipolar disorder (DSM-III-R) during the previous 3 years who were in remission at entry into the study.

A randomized, double-blind, placebo-controlled study of the effects of adjunctive paroxetine in panic disorder patients unsuccessfully treated with cognitive-behavioral therapy alone.

Background: Both cognitive-behavioral therapy and treatment with selective serotonin reuptake inhibitors (SSRIs) have proved to be effective in the treatment of panic disorder. The present study examined the effects of paroxetine added to continued cognitive-behavioral therapy in patients who were unsuccessfully treated with initial cognitive-behavioral therapy alone.

Method: 161 patients with panic disorder with or without agoraphobia (DSM-IV criteria) underwent a manual-guided cognitive-behavioral therapy of 15 sessions.

Addition of cognitive-behaviour therapy for obsessive-compulsive disorder patients non-responding to fluoxetine.

Objective: Selective serotonin re-uptake inhibitors (SSRIs) and cognitive behaviour therapy (CBT) have both proven to be effective in the treatment of obsessive compulsive disorder (OCD). It is generally recommended that adequate but unsuccessful SSRI treatment is supplemented with CBT, although only one empirical study was conducted to verify this recommendation. The present study examined the effects of supplemental CBT to continued fluoxetine treatment in OCD patients non-responding to fluoxetine alone.

The emotional Stroop: a comparison of panic disorder patients, obsessive-compulsive patients, and normal controls, in two experiments.

An emotional Stroop task with four word types (panic threat, obsessive-compulsive threat, general threat, and neutral) and two presentation conditions (supraliminal, subliminal) was used in two experiments. The first experiment involved 21 panic disorder (PD) patients and 20 normal controls; the second experiment 20 PD patients and 20 obsessive-compulsive patients. PD patients, obsessive-compulsive patients, and normal controls did not differ in Stroop interferences.

Motor initiation and execution in patients with conversion paralysis.

Motor initiation and motor execution in four patients with conversion paralysis were investigated in a non-affected motor modality (speech). In line with the hypothesis of dissociated control in conversion disorder [Cognit. Neuropsychiatry 8 (1) (2001) 21] motor initiation, but not response duration, was expected to be impaired.

Diagnosis at the first episode to differentiate antidepressant treatment responses in patients with mood and anxiety disorders.

Rationale: Co-morbidity of mood and anxiety disorders is often ignored in pharmacotreatment outcome studies and this complicates the interpretation of treatment response. The clinical trials are usually based on single categories from the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Objectives: The present study is a first attempt to differentiate the responses to antidepressants using a design that differs from that used in previous clinical trials.

Gilles de la Tourette's syndrome with and without obsessive-compulsive disorder compared with obsessive-compulsive disorder without tics: which symptoms discriminate?

Stereotyped repetitive behaviors occur in Gilles de la Tourette's Syndrome (GTS) and obsessive-compulsive disorder (OCD). The present study was undertaken to compare the distribution of obsessive-compulsive and Tourette-related impulsive behaviors in GTS with (+) OCD, GTS without (-) OCD, tic-free OCD, and control subjects. Fourteen GTS + OCD, 18 GTS-OCD, 21 OCD-tic, and 29 control subjects were evaluated using a semistructured interview designed to assess GTS and OCD-related repetitive behaviors.

Repetitive behaviors in Tourette's syndrome and OCD with and without tics: what are the differences?

Gilles de la Tourette Syndrome (GTS) and obsessive-compulsive disorder (OCD) share obsessive-compulsive phenomena. The aims of this study were to compare the OC symptom distribution between GTS and OCD and to investigate whether a subdivision of these phenomena into obsessions, compulsions and 'impulsions' is useful in distinguishing GTS and OCD patients. Thirty-two GTS, 31 OCD (10 with tics, 21 without tics) and 29 control subjects were studied using the Leiden repetitive behaviors semi-structured interview to assess GTS as well as OCD-related behaviors.

The question of symptom lateralization in conversion disorder.

Objective: The purpose of this study was to determine whether or not conversion symptoms are lateralized. Studies have shown a predominant left-oriented manifestation of symptoms for most somatoform disorders. The reports in the literature on the lateralization of conversion symptoms, however, are rather conflicting.

Lithium and carbamazepine in bipolar disorder.

Lithium is considered first choice in the prevention of prospective episodes in patients with bipolar disorder. However, efficacy is not satisfactory in all patients and side effects sometimes prevent the use of lithium. It is argued that efficacy in clinical practice may be less impressive than anticipated from clinical trials, and alternative treatments are beinu advocated increasingly for that reason, such as the anticonvulsants, carbamazepine and valproate.

The relationship between types and severity of repetitive behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder.

Background: This study investigated which categories of obsessive-compulsive and Tourette-related behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder (OCD) without tics are experienced as most severe across the study groups and what the differences are in symptom distribution between the study groups.

Method: Fourteen subjects with both Tourette's disorder and OCD, 18 subjects with Tourette's only, 21 subjects with OCD (no tics), and 29 control subjects were studied using a semistructured interview designed to equally assess Tourette- and OCD-related behaviors according to DSM-III-R criteria. Each reported repetitive behavior was evaluated on the presence of anxiety and on goal-directedness.