The Bergen 4-day treatment for panic disorder: implementation in a rural clinical setting.

INTRODUCTION: The Bergen 4-Day Treatment (B4DT) is a concentrated treatment with individually tailored exposure exercises. The format has shown promising results in the treatment of panic disorder. AIM: The aim of the current study was to investigate the effectiveness of the B4DT in a large sample in a rural clinical setting. METHOD: Fifty-eight patients with panic disorder were consecutively included using an open trial design. The primary outcome measure was the Panic Disorder Severity Scale. The Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9 were used as secondary outcome measures. Assessments were conducted at pretreatment, posttreatment, and 3-month follow-up. Treatment satisfaction was measured at posttreatment using the Client Satisfaction Questionnaire-8. RESULTS: There was a significant reduction in symptoms of panic disorder from pre- to posttreatment (d = 3.36) and from pretreatment to follow-up (d = 3.63). At posttreatment and follow-up, 72.4% and 81.0% of patients, respectively, were classified as in remission. Patients reported high treatment satisfaction, and there were significant reductions in symptoms of generalized anxiety and depression. CONCLUSION: The results from the current study replicated the findings from previous studies using a larger sample size. The findings indicate that the B4DT is a promising treatment format for panic disorder. The study also demonstrated that the treatment format can be successfully implemented in new rural clinics.

Treatment of obsessive-compulsive disorder: personal follow-up of a 10-year material from an outpatient county clinic.

Individuals who suffer from obsessive-compulsive disorder (OCD) experience obsessive thoughts and/or urges to engage in compulsive behaviours. The condition causes severe discomfort and, in many cases, leads to serious impairment in social and work-related functioning. During the past decade, the Department of Psychiatry at Førde Central Hospital has systematically offered a combination of exposure with response prevention and antidepressant medication to these patients. In this paper, we describe our treatment model, including two case histories, and evaluate the outcome of the first 25 patients, who were included in this prospective study. They were evaluated at the onset, at the end of treatment and at follow-up, 1-10 years after treatment cessation. We employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Checklist (OCC) and Beck Depression Inventory (BDI). The mean scores for obsessions, compulsions and depression were significantly reduced after treatment. Further improvement occurred during the follow-up period. Effect sizes were above 1.3 on all instruments. Eleven participants were gainfully employed prior to treatment, 14 at the end of treatment and 18 at follow-up. The study included few participants, and rates of improvement were not compared with a control group. We therefore cannot conclude that the positive changes were caused by the treatment, but lasting spontaneous remission among patients suffering from OCD is rare. The study shows that a county outpatient psychiatric unit can utilize methods that have previously been shown to be effective in highly specialized treatment facilities, with good results.