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Psychotherapy for panic disorder with or without agoraphobia in adults

Michelle Craske, PhD
Section Editor
Murray B Stein, MD, MPH
Deputy Editor
Richard Hermann, MD


Panic disorder and agoraphobia are chronic psychiatric disorders characterized by recurrent panic attacks, at least some of which are unexpected, accompanied either by anxiety about having future attacks or about the implications of attacks (eg, undiscovered medical illness, possible sudden death or insanity), or by a change in behavior due to attacks (eg, avoidance of certain situations, recurrent requests for medical tests) [1].

While up to a third of the population will have a panic attack in their lifetime, only about 10 percent of this group (about 3 percent of the population) will go on to develop panic disorder [2]. Clinical trials have found that both pharmacologic and psychotherapeutic approaches are efficacious for panic disorder. With the revision of DSM-IV to DSM-5, agoraphobia is diagnosed independently of panic disorder [1]. Agoraphobia frequently but not always accompanies panic disorder.

This topic addresses psychotherapy for panic disorder and agoraphobia in adults. Our approach to selecting treatments for panic disorder with or without agoraphobia are addressed separately. Pharmacotherapy for panic disorder with or without agoraphobia are also addressed separately. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of panic disorder are also addressed separately. The epidemiology, pathogenesis, clinical manifestations, course, and diagnosis of agoraphobia are also addressed separately. (See "Approach to treating panic disorder with or without agoraphobia in adults" and "Pharmacotherapy for panic disorder with or without agoraphobia in adults" and "Panic disorder in adults: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis" and "Agoraphobia in adults: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis".)


Our approach to selecting among treatments for panic disorder, including the use of pharmacotherapy and psychotherapy, is discussed separately. (See "Approach to treating panic disorder with or without agoraphobia in adults".)


Among psychosocial treatments for panic disorder, cognitive-behavioral therapy (CBT) is most extensively supported by clinical trials. (See 'Efficacy' below.)

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Literature review current through: Nov 2017. | This topic last updated: May 26, 2017.
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