Guided self-help via Internet is a promising way of treating panic disorder (PD). The present study examined the effects of a self-help program via Internet with weekly therapist contact for PD after disseminated to a new country. Predictors of outcome were also examined. The study was an open trial with 27 participants with PD with or without agoraphobia as their primary diagnose. Medium to large effects on PD-symptoms were reported after treatment and at 6 months follow-up, with smaller effects on secondary outcome measures, i.e. depression, interpersonal problems, and sleep problem. The attrition rate of 30% in present study was higher than in Swedish studies. Predictor analysis showed that participants with longer duration of PD-symptoms had less improvement on all outcome measurers, whereas higher age predicted more improvement. The guided self-help program remained effective when disseminated to a new country, but the high attrition rate needs to be addressed in future studies.
Panic disorder (PD) have a lifetime prevalence at nearly 5% in the adult population (Kessler et al., 2006a), resulting in substantial costs both for those with the diagnosis and for society (Deacon et al., 2008 and Kessler et al., 2006b). There are several effective treatments for PD, but there is a challenge to make these available for those in need of treatment (Collins et al., 2004 and McManus et al., 2008). Guided self-help treatment based on Cognitive Behavioural Therapy (CBT) delivered through the Internet is a promising way of helping those with PD (Kaltenthaler et al., 2004 and Titov, 2007).
The effects of a CBT-based guided self-help program for PD developed by the Swedish research group led by Andersson and Carlbring have been reported in four randomized controlled trials (Carlbring et al., 2003, Carlbring et al., 2001, Carlbring et al., 2005 and Carlbring et al., 2006). Within-group effect sizes on primary outcome measures in these studies are reported to be medium to large, and when compared with therapist delivered therapy between-group effect sizes are reported to be small (Carlbring et al., 2005). The primary aim of present study was to examine effects of the guided self-help program for PD developed by Andersson and Carlbring when disseminated to a new country (from Sweden to Norway). The second aim of the study was to examine effects on symptoms and problems additional to the targeted PD-symptoms. Effects on depressive symptoms and quality of life from this treatment have been reported (Carlbring et al., 2003 and Carlbring et al., 2006), but outcome on sleep and interpersonal problems should also be of interest, as these are two domains in which those who suffers from PD often report problems (Hoffart, Hackmann, & Sexton, 2006). The third aim of the study was to examine possible predictors of outcome. There are few consistent findings regarding predictors of outcome in the novel field of guided self-help via Internet, and more research on predictors is needed (Andersson, Carlbring, & Grimund, 2008).
