Eye Movement Desensitisation and Reprocessing (EMDR) versus Cognitive Behavioral Therapy (CBT) in the treatment of panic disorders with or without agorafobia: A Randomized Controlled Trial.

Numerous studies has been done to the impact of psychological interventions in
the treatment of panic disorders with or without agoraphobia. Several
controlled studies has showed that Cognitive Behavior Therapy (CBT) appear to
be effective. Patients who have been treated with CBT are between 40 up to 90 %
free of panic attacks. The differences in treatment effects are strongly
stipulated by the selected population. When there is incidence of more
agoraphobia and/or presence of more co-morbidity, the success percentage of the
treatment goes down. Nowadays it*s clear that CBT for many patients, also on
the longer period, is an effective treatment. Nevertheless there is a group of
patients which after CBT treatment need more or additional treatment.
Furthermore there are indications that when the follow-up period longer lasts,
the chance becomes larger that new complaint occurs and that a patient who was
after CBT symptom free has a increased risk on developing other affective
impairments. Although the effectiveness of EMDR has been extensively evaluated
in its approach to trauma and post traumatic stress disorder (PTSS), this can*t
be said of the application of EMDR in the field of other anxiety disorders like
panic disorders with or without agoraphobia. From a theoretical point of view
there are several arguments for which EMDR could play a role in the treatment
of panic disorders. A first panic attack is traumatizing for many patients
because of its unexpectedly and life-threatening feelings and losing control.
The first panic attack has a conditioning frightening impact for a next panic
attack. There is also evidence that a first panic attack has the same
development on the information process as a traumatic event which leads to
PTSS. Research showed that panic memories have a lot in common with trauma
memories look like PTSS. In addition, there are indications that a panic
disorder often start after a stressful life event.

The aim of this study is to compare Eye Movement Desensitization and
Reprocessing (EMDR), with an empirically proven effective treatment, namely
Cognitive Behavioral Therapy (CBT) in the treatment of panic disorders with or
without agoraphobia. The expectation is that EMDR in the treatment of a panic
disorders with or without agoraphobia, as well as CBT leads, to reduction of
the symptoms of the panic disorder. This reduction of symptoms, so the
expectation, will be larger for the EMDR then for CBT when patients nowadays
still have charge of traumatic experience memories, like for example the first
panic attack. Furthermore the quality of life is considered as an important
measuring outcome at numerous psychiatric and physical disorders. Research has
shown that the quality of life improved at patients with a panic disorder after
CBT. This research will also examine what the impact of the treatment is for
the quality of life. The expectation is that EMDR in the treatment of a panic
disorder with or without agoraphobia, as well as CBT lead, to an improvement of
the quality of life. This improvement of quality of life, so the expectation,
will be larger for the EMDR then for CBT when patients nowadays still have
charge of traumatic experience memories like for example the first panic
attack.

This study is a Randomized Controlled Trial (RCT) with a follow-up period of 3
months. Patients will be assigned at random to one of these two treatment
groups (EMDR versus CBT). The inclusion period for participation will be two
years and three months. The research has a total duration of two and a half
years.

Two treatments will be compared directly with each other (EMDR vs CBT). A
treatment protocol will be used in both group, which exists of 13 weekly
treatment sessions which take approximately 45 to 60 minutes each time. The
interventions in both treatment groups differ from each other from the first
treatment session.

There are no health risks attached to participation in this study.