Cognitive-behavioral therapy for panic disorder with agoraphobia in older people: a comparison with younger patients
Publication year
2014Number of pages
9 p.
Source
Depression and Anxiety, 31, 8, (2014), pp. 669-677ISSN
Publication type
Article / Letter to editor

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Organization
Psychiatry
SW OZ BSI KLP
Journal title
Depression and Anxiety
Volume
vol. 31
Issue
iss. 8
Languages used
English (eng)
Page start
p. 669
Page end
p. 677
Subject
Experimental Psychopathology and Treatment; Radboudumc 0: Other Research DCMN: Donders Center for Medical Neuroscience; Radboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences; Radboudumc 13: Stress-related disorders DCMN: Donders Center for Medical NeuroscienceAbstract
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. Primary outcome measures were avoidance behavior (Mobility Inventory Avoidance scale) and agoraphobic cognitions (Agoraphobic Cognitions Questionnaire), with values of the younger (18-60 years) and older (>= 60 years) patients being compared using mixed linear models adjusted for baseline inequalities, and predictive effects of chronological age, age at PDA onset and duration of illness (DOI) being examined using multiple linear regressions. Results: Attrition rates were 2/31 (6%) for the over-60s and 31/141 (22%) for the under-60s group (chi(2) = 3.43, df = 1, P = .06). Patients in both age groups improved on all outcome measures with moderate-to-large effect sizes. Avoidance behavior had improved significantly more in the 60+ group (F = 4.52, df = 1,134, P = .035), with agoraphobic cognitions showing no age-related differences. Baseline severity of agoraphobic avoidance and agoraphobic cognitions were the most salient predictors of outcome (range standardized betas 0.59 through 0.76, all P-values < .001). Apart from a superior reduction of agoraphobic avoidance in the 60+ participants (beta = -0.30, P = .037), chronological age was not related to outcome, while in the older patients higher chronological age, late-onset type and short DOI were linked to superior improvement of agoraphobic avoidance. Conclusions: CBT appears feasible for 60+ PDA-patients, yielding outcomes that are similar and sometimes even superior to those obtained in younger patients.
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- Academic publications [204994]
- Faculty of Medical Sciences [81051]
- Faculty of Social Sciences [27347]
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