ABSTRACT
BACKGROUND: Many patients with phobia/panic find it hard to access effective treatment. AIMS: To test the feasibility of computer-guided exposure therapy for phobia/panic. METHOD: Self-referrals were screened for 20 min and, if suitable, had six sessions of computer-guided self-help (from a system called FearFighter). Pre- and post-treatment ratings of 54 patients were compared with those of 31 similar out-patients with phobia/panic who received the same treatment guided by a clinician. RESULTS: At pre-treatment, computer-guided cases were slightly less severe than clinician-guided patients. In a post-treatment intent-to-treat analysis, both groups improved comparably but computer-guided patients spent 86% less time with a clinician than did purely clinician-guided patients, who had no access to the computer system. CONCLUSIONS: Computer-guided self-exposure therapy appeared feasible and effective for self-referrals and saved much clinician time. A controlled study is now needed.
Subject(s)
Panic Disorder/therapy , Patient Acceptance of Health Care , Phobic Disorders/therapy , Self Care/methods , Therapy, Computer-Assisted/methods , Adult , Feasibility Studies , Female , Health Services Accessibility/organization & administration , Humans , Male , Mental Health Services/organization & administration , Mental Health Services/statistics & numerical data , Psychotherapy/methods , Treatment OutcomeABSTRACT
BACKGROUND: Family studies of post-traumatic stress disorder (PTSD) have given inconsistent results to date. Identifying predisposing factors in PTSD compared to anxiety disorders may help to clarify the classification of PTSD as a diagnostic entity. METHOD: Retrospective case note study of 87 PTSD patients who participated in an RCT, and 51 PTSD patients and 87 agoraphobics treated routinely in outpatients. RESULTS: Compared to agoraphobics, PTSD patients had significantly less family history of anxiety disorder but not mental illness in general. They also had significantly less personal history of mental illness prior to the index episode. CONCLUSIONS: Trauma precipitated PTSD in subjects who had significantly fewer premorbid predisposing factors than did agoraphobics. Such factors may predispose agoraphobics to become psychiatrically ill after more minor trauma. Research is needed to systematically compare the events which precipitate PTSD as opposed to agoraphobia and other anxiety disorders.
Subject(s)
Family/psychology , Mental Disorders/genetics , Stress Disorders, Post-Traumatic/psychology , Adult , Depression/psychology , Female , Genetic Predisposition to Disease , Humans , Male , Retrospective Studies , Risk Factors , Stress Disorders, Post-Traumatic/epidemiologyABSTRACT
Post traumatic stress disorder affects up to 1 per cent of the population, yet there are few specially trained nurses who are able to offer appropriate care and treatment. This article explores this condition, its treatment and the need for more suitably qualified nurses to fill this gap.
