Effects of psychological intervention on panic attack patients in the emergency department.

For patients initially seen in the emergency department (ED) for panic attack, this study evaluated the effect of two brief psychological interventions in the ED on later utilization of emergency, psychiatric, and nonpsychiatric medical department services. Each of the two intervention groups received usual ED care, a brochure on panic disorder, and a referral to treatment at the psychiatry department; one of the two groups also received 20-30 minutes of contact with a representative from the psychiatry department. Both intervention groups were compared with a historical control group. The contact condition reduced ED use after the initial visit to the ED, although all three groups had more visits to the psychiatry department and to all nonpsychiatric departments. This decrease was statistically significant (P = 0.0017) when compared with the brochure condition but not when compared with the historical control group (P = 0.0672). The decrease seen in ED use is an important therapeutic and economic finding.

The desensitization derby: in vivo down the backstretch, imaginal at the wire?

Recontacted 17 Ss who had undergone successful imaginal or in vivo desensitization for snake phobia and had been evaluated pre- and posttreatment for a 9-month follow-up. Main findings were that: (a) overall treatment gains were maintained through the follow-up period; (b) differential gains in favor of the in vivo technique on one behavioral and two self-report snake-specific criteria were dissipated; and (c) imaginal Ss registered a reduction in self-rated fear during an approach task from posttesting to follow-up. Results are discussed in relation to the notion of cognitive rehearsal as a means of self-reinforcing treatment gains.