A review of self-management interventions for panic disorders, phobias, and obsessive compulsive disorder

Interdisciplinary Research Centre in Health, School of Health and Social Sciences, Coventry University, Coventry, UK.
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 05/2005; 111(4):272-85. DOI: 10.1111/j.1600-0447.2005.00499.x
Source: PubMed


To review current evidence for the clinical and cost-effectiveness of self-management interventions for panic disorder, phobias and obsessive-compulsive disorder (OCD).
Papers were identified through computerized searches of databases for the years between 1995 and 2003, manual searches and personal contacts. Only randomized-controlled trials were reviewed.
Ten studies were identified (one OCD, five panic disorder, four phobias). Effective self-management interventions included cognitive-behavioural therapy (CBT) and exposure to the trigger stimuli for phobias and panic disorders. All involved homework. There was evidence of effectiveness in terms of improved symptoms and psychological wellbeing when compared with standard care, waiting list or relaxation. Brief interventions and computer-based interventions were effective for most participants. In terms of quality, studies were mainly based on small samples, lacked long-term follow-up, and failed to address cost-effectiveness.
Despite the limitations of reviewed studies, there appears to be sufficient evidence to warrant greater exploration of self-management in these disorders.

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    • "Strategies of self-management support are based on knowledge and information transfer to increase health literacy and facilitate the development of skills, as well as promoting the use of available health resources [12]. Self-management support promotes control and responsibility, thus strengthening the patients’ confidence in their own ability to manage his or her psychological symptoms, as well as their impact on his or her daily life [20]. "
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    • "A review of the literature on Internetbased mental health programs informed the design of the material to maximize its effectiveness and usability (e.g., Barlow et al., 2005; Griffiths et al., 2007; Spek et al., 2006). Specifically, the program includes weekly phone and email contact with a coach, and is designed to be an interactive work-book, with examples and activities to encourage practice and enhance learning of material. "
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    • "Panic disorder (with or without agoraphobia) is a common mental disorder with 12 month prevalence in Australia of approximately 3.5% (Andrews, Henderson, & Hall, 2001) and is associated with considerable disability (Massion, Warshaw, & Keller, 1993). Panic disorder can be treated effectively with cognitive behavioural therapy (CBT) (Barlow, Ellard, Hainsworth, Jones, & Fisher, 2005; Butler, Chapman, Forman, & Beck, 2006; Otto, Smits, and Reese, 2004), however, in Australia only approximately 39% of people with panic disorder report seeking treatment in the preceding 12 months (Sanderson, Andrews, Corry, & Lapsley, 2003). Barriers to treatment seeking for panic disorder include the avoidance associated with the agoraphobia that is often present, as well as reasons common to low treatment seeking for other common mental disorders including barriers associated with geographical location, the lack of trained therapists, the potential expense of treatment, and lack of awareness about treatment options and effectiveness (Proudfoot, 2004; Titov, 2007). "

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