We used individual patient data from the 2 large randomized controlled trials of panic disorder with or without agoraphobia conducted by 4 of the authors (Barlow, Gorman, Shear and Woods). The first was the Multi-Center Collaborative Treatment Study of Panic Disorder (MCCTSPD) [18 (link)], designed to compare medication, cognitive behavioral treatment (CBT) and their combination. A total of 312 patients with panic disorder (DSM-III-R) recruited across 4 sites, were randomly assigned to receive imipramine only, cognitive-behavioral therapy only, placebo only, CBT plus imipramine or CBT plus placebo. The patients were treated weekly for 3 months (acute phase treatment), and responders were then seen monthly for 6 months (maintenance treatment) and those who maintained their response were followed up for 6 months after treatment discontinuation. Study participants were administered the PDSS and the CGI-Severity at baseline, and then the PDSS, the CGI-Severity and the CGI-Improvement at end of acute phase treatment, at end of maintenance treatment and at follow-up. The outcome assessors were social workers, doctoral level psychologists or advanced doctoral psychology students who had been trained to reliability prior to the beginning of the study, and participated in bimonthly conference calls to ensure continued reliability. In addition, all assessment sessions were audiotaped and inter-rater reliability was determined for a randomly selected 10% of these interviews. Reliability on main measures remained above 90%.
The second study, Treatment of Panic Disorder Long-Term Study (TOPDLTS), was designed to determine long term outcome following open treatment with CBT. The design of this study entailed an acute phase open treatment with CBT during which all participants diagnosed with panic disorder with or without agoraphobia (DSM-IV) received 11 weeks of CBT (completer n=256). The current paper includes data from the acute phase open trial [19 (link)]. Participants were administered the PDSS at baseline, and the PDSS plus the CGI-Improvement at post treatment. As in our first study, evaluators had been trained to reliability, participated in monthly supervision conference calls but were kept blind to the allocated treatment. 10% of all assessments were randomly selected for monitoring throughout the course of the study. The intraclass correlation coefficient for the PDSS was 0.99.
The second study, Treatment of Panic Disorder Long-Term Study (TOPDLTS), was designed to determine long term outcome following open treatment with CBT. The design of this study entailed an acute phase open treatment with CBT during which all participants diagnosed with panic disorder with or without agoraphobia (DSM-IV) received 11 weeks of CBT (completer n=256). The current paper includes data from the acute phase open trial [19 (link)]. Participants were administered the PDSS at baseline, and the PDSS plus the CGI-Improvement at post treatment. As in our first study, evaluators had been trained to reliability, participated in monthly supervision conference calls but were kept blind to the allocated treatment. 10% of all assessments were randomly selected for monitoring throughout the course of the study. The intraclass correlation coefficient for the PDSS was 0.99.