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T-Space at The University of Toronto Libraries >
Journal of Medical Internet Research >
Volume 10 (2008)  >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1807/16662

Title: Therapist-Assisted, Internet-Based Treatment for Panic Disorder: Can General Practitioners Achieve Comparable Patient Outcomes to Psychologists?
Authors: Shandley, Kerrie
Austin, David William
Klein, Britt
Pier, Ciaran
Schattner, Peter
Pierce, David
Wade, Victoria
Eysenbach, Gunther
Keywords: Original Paper
Panic disorder
mental health
general practice
cognitive behavioral therapy
Issue Date: 19-May-2008
Publisher: Gunther Eysenbach; Centre for Global eHealth Innovation, Toronto, Canada
Citation: Kerrie Shandley, David William Austin, Britt Klein, Ciaran Pier, Peter Schattner, David Pierce, Victoria Wade. Therapist-Assisted, Internet-Based Treatment for Panic Disorder: Can General Practitioners Achieve Comparable Patient Outcomes to Psychologists?. J Med Internet Res 2008;10(2):e14 <URL: http://www.jmir.org/2008/2/e14/>
Abstract: [This item is a preserved copy and is not necessarily the most recent version. To view the current item, visit http://www.jmir.org/2008/2/e14/ ] Background: Mental illness is an escalating concern worldwide. The management of disorders such as anxiety and depression largely falls to family doctors or general practitioners (GPs). However, GPs are often too time constrained and may lack the necessary training to adequately manage the needs of such patients. Evidence-based Internet interventions represent a potentially valuable resource to reduce the burden of care and the cost of managing mental health disorders within primary care settings and, at the same time, improve patient outcomes. Objective: The present study sought to extend the efficacy of a therapist-assisted Internet treatment program for panic disorder, Panic Online, by determining whether comparable outcomes could be achieved and maintained when Panic Online was supported by either GPs or psychologists. Methods: Via a natural groups design, 96 people with a primary diagnosis of panic disorder (with or without agoraphobia) completed the Panic Online program over 12 weeks with the therapeutic assistance of their GP (n = 53), who had received specialist training in cognitive behavioral therapy, or a clinical psychologist (n = 43). Participants completed a clinical diagnostic telephone interview, conducted by a psychologist, and a set of online questionnaires to assess panic-related symptoms at three time periods (pretreatment, posttreatment, and 6 month follow-up). Results: Both treatments led to clinically significant improvements on measures of panic and panic-related symptomatology from pretreatment to posttreatment. Both groups were shown to significantly improve over time. Improvements for both groups were maintained at follow-up; however, the groups did differ significantly on two quality of life domains: physical (F1,82 = 9.13, P = .00) and environmental (F1,82 = 4.41, P = .04). The attrition rate was significantly higher among those being treated by their GP (χ 2 1 = 4.40, P = .02, N = 96). Conclusions: This study provides evidence that Internet-based interventions are an effective adjunct to existing mental health care systems. Consequently, this may facilitate and enhance the delivery of evidence-based mental health treatments to increasingly large segments of the population via primary care systems and through suitably trained health professionals.
Description: Reviewer: Anonymous,
Reviewer: Carlbring, Per
Reviewer: Andersson, Gerhard
URI: http://dx.doi.org/ 10.2196/jmir.1033
ISSN: 1438-8871
Rights: © Kerrie Shandley, David William Austin, Britt Klein, Ciaran Pier, Peter Schattner, David Pierce, Victoria Wade. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 19.05.2008. Except where otherwise noted, articles published in the Journal of Medical Internet Research are distributed under the terms of the Creative Commons Attribution License (http://www.creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided 1) the original work is properly cited, including full bibliographic details and the original article URL on www.jmir.org, and 2) this statement is included.
Appears in Collections:Volume 10 (2008)

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