Nuevos desarrollos en el tratamiento del trastorno de pánico

El objetivo de este articulo consiste en proporcionar una revision sobre los desarrollos recientes producidos en la investigacion del tratamiento del trastorno de panico. Aunque los estudios controlados apenas han comenzado a iniciarse en el momento presente, los defensores del uso de farmacos han apoyado de forma abrumadora la utilizacion de los inhibidores selectivos de recaptacion de serotonina (selective serotonin reuptake inhibitors, SSRIs) como el farmaco apropiado para el tratamiento del panico. Los terapeutas cognitivo-conductuales han documentado mas a fondo la efectividad de sus aproximaciones, a la vez que han ocurrido desarrollos sorprendentes. Algunos datos sugieren que la exposicion no necesita estar incluida para que ciertos tratamientos psicosociales sean efectivos, mientras que otros estudios han demostrado que los elementos cognitivos anaden poco mas a la terapia de exposicion. Otros desarrollos adicionales se han referido tanto al establecimiento de criterios estandarizados para evaluar el trastorno de panico cuando se aplican indistintamente farmacos y tratamiento psicologico, como a la clarificacion de metodos apropiados para planificar e interpretar intervenciones controladas.

[1]  M. A. van den Hout,et al.  Exposure reduced agoraphobia but not panic, and cognitive therapy reduced panic but not agoraphobia. , 1994, Behaviour research and therapy.

[2]  D. Black,et al.  A comparison of fluvoxamine, cognitive therapy, and placebo in the treatment of panic disorder. , 1993, Archives of general psychiatry.

[3]  M. Pollack,et al.  A meta-analysis of treatment outcome for panic disorder , 1995 .

[4]  E. Hollander,et al.  Fluoxetine in panic disorder. , 1990, Journal of clinical psychopharmacology.

[5]  D. Chambless,et al.  Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. , 1984, Journal of consulting and clinical psychology.

[6]  P. Salkovskis,et al.  A Comparison of Cognitive Therapy, Applied Relaxation and Imipramine in the Treatment of Panic Disorder , 1994, British Journal of Psychiatry.

[7]  A. Nuzzarello,et al.  Does cognitive behavior therapy assist slow-taper alprazolam discontinuation in panic disorder? , 1994, The American journal of psychiatry.

[8]  J. Gauthier,et al.  Reduced therapist contact in the cognitive behavioral treatment of panic disorder , 1994 .

[9]  D. Barlow,et al.  A comparison of alprazolam and behavior therapy in treatment of panic disorder. , 1990, Journal of consulting and clinical psychology.

[10]  G. Clum,et al.  A comparison of bibliotherapy and group therapy in the treatment of panic disorder. , 1994, Journal of consulting and clinical psychology.

[11]  M. Craske,et al.  Brief cognitive-behavioral versus nondirective therapy for panic disorder. , 1995, Journal of behavior therapy and experimental psychiatry.

[12]  A. Leon,et al.  Cognitive behavioral treatment compared with nonprescriptive treatment of panic disorder. , 1994, Archives of general psychiatry.

[13]  R. McNally.  Methodological controversies in the treatment of panic disorder. , 1996, Journal of consulting and clinical psychology.

[14]  J. Rosenbaum,et al.  Discontinuation of benzodiazepine treatment: efficacy of cognitive-behavioral therapy for patients with panic disorder. , 1993, The American journal of psychiatry.

[15]  D. Klein.  Preventing hung juries about therapy studies. , 1996 .

[16]  D. Black,et al.  The abrupt discontinuation of fluvoxamine in patients with panic disorder. , 1993, The Journal of clinical psychiatry.

[17]  J. Lucas,et al.  Group cognitive-behavioral treatment of panic disorder. , 1993, Behaviour research and therapy.

[18]  D. Mcleod,et al.  Effect of fluvoxamine on panic disorder. , 1993, Journal of clinical psychopharmacology.

[19]  D. Klein.  False suffocation alarms, spontaneous panics, and related conditions. An integrative hypothesis. , 1993, Archives of general psychiatry.

[20]  Lars-Göran Öst,et al.  Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder. , 1995, Behaviour research and therapy.

[21]  A. Hoffart.  A comparison of cognitive and guided mastery therapy of agoraphobia. , 1995, Behaviour research and therapy.

[22]  R. McNally,et al.  Validation of the spanish version of the Anxiety Sensitivity Index in a clinical sample. , 1996, Behaviour research and therapy.

[23]  I. Marks,et al.  Imipramine and brief therapists-aided exposure in agoraphobics having self-exposure homework. , 1983, Archives of general psychiatry.

[24]  S. Reiss,et al.  Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. , 1986, Behaviour research and therapy.

[25]  Lars-Göran Öst.  Applied relaxation vs progressive relaxation in the treatment of panic disorder. , 1988 .

[26]  M K Shear,et al.  Standardized assessment for panic disorder research. A conference report. , 1994, Archives of general psychiatry.

[27]  David H. Barlow,et al.  Behavioral treatment of panic disorder , 1989 .

[28]  J. Gorman,et al.  An Open Trial of Fluoxetine in the Treatment of Panic Attacks , 1987, Journal of clinical psychopharmacology.

[29]  J. Beck,et al.  Comparison of cognitive therapy and relaxation training for panic disorder. , 1994, Journal of consulting and clinical psychology.

[30]  D. Clark.  Cognitive Therapy in the Treatment of Anxiety Disorders , 1995 .

[31]  A. Bystritsky,et al.  Double-blind pilot trial of desipramine versus fluoxetine in panic patients. , 1994, Anxiety.

[32]  K. Behnke,et al.  Paroxetine in the Treatment of Panic Disorder a Randomised, Double-Blind, Placebo-Controlled Study , 1995, British Journal of Psychiatry.

[33]  S. Woody,et al.  Suffocation false alarms and efficacy of cognitive behavioral therapy for panic disorder , 1996 .