Long-term follow-up of the Bergen 4-day treatment for panic disorder during the COVID-19 pandemic

Abstract

The COVID-19 pandemic has necessitated essential modifications to the administration of psychotherapy for patients with panic disorder (PD) through the increased use of videoconferencing. However, the effect of this change on treatment efficacy remains unclear. The current study is a long-term (1.5 years) investigation of the Bergen 4-day treatment (B4DT) for PD delivered as a combination of videoconferencing and face-to-face therapy. This study reported the long-term outcomes of B4DT for PD when delivered in a hybrid format. The B4DT includes multiple components delivered over four consecutive days. As the pandemic unfolded, B4DT was adapted to include different levels of in-person versus videoconference delivery, depending on COVID-19 infection rates and public health recommendations. Outcome measures included clinician-rated illness severity on the Panic Disorder Severity Scale (PDSS) and patient-rated symptoms of PD, agoraphobia, generalized anxiety, and depression. Follow-up treatment, work status, and current medications were assessed. We used multilevel models to estimate whether clinical improvement was maintained over time. Treatment effects achieved at three months were maintained at the 1.5-year follow-up. Patients who completed the PDSS scored M = 14.78 (SD = 3.37) before treatment, M = 5.88 (5.28) at the three-month follow-up (d = 2.01), and M = 5.44 (SD = 5.12) at the long-term follow-up (d = 2.15). The reduction in generalized anxiety and depression symptoms was maintained over time. The current study suggests that B4DT can be delivered successfully in a combination of face-to-face and videoconference therapy sessions. Moreover, long-term effects are maintained, even during the challenging circumstances of the pandemic.

Keywords

• Panic disorder
• concentrated treatment
• exposure
• long-term
• B4DT
• CBT