The effectiveness of cognitive behavioral therapy on rumination and severity of panic attacks in people with panic disorder and comorbid depression.

Investigating the effectiveness of CBT treatment on panic attacks and rumination

A controlled, parallel-group, unblinded, randomized, phase 2 clinical trial on 15 patients. A random number table was used for randomization.

Initially, the required approvals were obtained from the faculty, and the research protocol was reviewed and approved by the Ethics Committee of Islamic Azad University, Ayatollah Amoli Branch (Ethics Code: IR.IAU.AMOL.REC.1403.070). Subsequently, with permission from the Welfare Organization of Mazandaran Province, invitation letters were sent to its affiliated centers in the eastern and central regions of the province. Eight psychological centers agreed to cooperate. A licensed clinical psychologist conducted interviews with 145 clients diagnosed with Panic Disorder, among whom 67 were formally diagnosed with comorbid Major Depressive Disorder. From this pool, 30 individuals were selected using a random number table and randomly allocated into two groups of 15 (intervention and control) using sealed envelopes. No blinding was performed.

Inclusion criteria: definite diagnosis of panic disorder along with co-occurring major depressive disorder based on DSM5-tr criteria, being a resident of Mazandaran, being a welfare referent. Exclusion criteria: diagnosis of another mental disorder

The intervention group consists of patients with panic disorder and comorbid major depression who receive a 12-session cognitive behavioral therapy intervention. The comparison group consists of patients with panic disorder and comorbid major depression who remain on the waiting list.

Panic attacks - Rumination

Following the initial diagnostic screening, a total of 67 patients diagnosed with Panic Disorder who also met the criteria for comorbid Major Depressive Disorder (MDD) were enrolled in the study. Among these, 30 individuals who met the final eligibility criteria were selected for inclusion in the trial. In this study, simple randomization with an individual-level unit of randomization was employed. Given the sample size (n=30) and the lack of necessity to balance the groups with respect to baseline covariates, no stratification based on age, gender, or treatment center was performed. The random allocation sequence for assigning participants to either the intervention or control group was generated using a random number table. To prevent bias in the allocation process, the generated random sequence was placed inside opaque, identical, tamper-proof, and sealed envelopes. These envelopes were prepared and numbered by an individual independent of the assessment and intervention processes. Following the initial evaluations conducted by the clinical psychologist, the envelope corresponding to each participant was opened in order of entry, and each individual was allocated to one of the two groups (intervention or control) based on the number contained within the envelope.

Pre-test and post-test data on dependent variables can be shared after de-identifying individuals.

Since the beginning of the year 1406 AH

University researchers with an official letter from their supervisor

No further analysis is permitted.

Corresponding author or supervisor

A written request with the seal of the faculty's research vice chancellor is sufficient.