Objective: Data regarding the potential association between the outcome of psychotherapy of panic disorder (PD) and biological parameters are few. In 21 (16 females) consecutively referred, medication-free, acutely ill PD outpatients, without comorbidities, except agoraphobia, we systematically explored for potential neuroendocrine and clinical correlates of response to a brief cognitive behavior therapy (CBT). Methods: Cortisol and adrenocorticotropic hormone (ACTH) basal plasma levels were measured. Measures of psychopathology: (a) Symptom Checklist–90-Revised (SCL-90-R), (b) Clinical Global Impressions-Improvement (CGI-I) Scale, (c) Agoraphobic Cognitions Questionnaire (ACQ), and (d) Mobility Inventory (MI)-alone subscale. Results: Nonresponders to CBT (CGI-I #x3e;2; N = 6) – as compared to the responders (CGI-I ≤2; N = 15) – demonstrated significantly higher cortisol and ACTH basal plasma concentrations. These differences were much stronger when only female patients (nonresponders = 4; responders = 12) were taken into consideration. Regarding psychopathology, nonresponders to CBT suffered from more severe agoraphobia (MI-alone) at baseline. On the contrary, more intense manifestations of anger (SCL-90-R) at baseline were associated with a better treatment outcome. Response to CBT was associated with significant reductions in all SCL-90-R subscales, more pronounced for “phobic anxiety” and “anxiety” subscales. Conclusions: This study suggests that in acutely ill, medication-free PD patients, response to CBT may be associated with certain hormonal and clinical parameters at baseline.
Neuropsychobiology

中文翻译：

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应激激素作为恐慌症认知行为治疗反应的预测因子

目的：关于惊恐障碍（PD）心理治疗结果与生物学参数之间潜在关联的数据很少。在 21 名（16 名女性）连续转诊的、无药物治疗的急性 PD 门诊患者中，除了广场恐惧症外，没有合并症，我们系统地探索了对简短认知行为疗法 (CBT) 反应的潜在神经内分泌和临床相关性。方法：测量皮质醇和促肾上腺皮质激素（ACTH）的基础血浆水平。精神病理学测量：(a) 症状检查表–90 修订版 (SCL-90-R)，(b) 临床整体印象改善 (CGI-I) 量表，(c) 广场恐惧症认知问卷 (ACQ)，和 (d)流动性清单（MI）-单独的分量表。结果：对 CBT 无反应者 (CGI-I #x3e;2;N = 6) – 与响应者 (CGI-I ≤2; N = 15) 相比 – 表现出显着更高的皮质醇和 ACTH 基础血浆浓度。当仅考虑女性患者（无反应者 = 4；有反应者 = 12）时，这些差异要大得多。关于精神病理学，对 CBT 无反应者在基线时患有更严重的广场恐惧症（仅 MI）。相反，基线时更强烈的愤怒表现（SCL-90-R）与更好的治疗结果相关。对 CBT 的反应与所有 SCL-90-R 分量表的显着降低有关，对于“恐惧性焦虑”和“焦虑”分量表更为明显。结论：这项研究表明，在急性病、无药物治疗的 PD 患者中，对 CBT 的反应可能与基线时的某些激素和临床参数有关。
神经心理生物学