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Two-Year Follow-Up of Agoraphobics after Exposure and Imipramine

Published online by Cambridge University Press:  29 January 2018

S. D. Cohen
Affiliation:
Cassel Hospital, Ham Common, Richmond, Surrey; Institute of Psychiatry, 99 Denmark Hill, London SE5 SAF and Bethlem and Maudsley Hospitals, Denmark Hill, London SE5 8AZ
W. Monteiro
Affiliation:
Institute of Psychiatry; Bethlem and Maudsley Hospitals, London SE5 8AZ
I. M. Marks
Affiliation:
Institute of Psychiatry, De Crespigny Park, London SE5 8AF; Bethlem and Maudsley Hospitals, Denmark Hill, London SE5 8AZ

Summary

Forty-five agoraphobic out-patients were randomly assigned to treatment with imipramine or placebo, and also to brief therapist-aided exposure or relaxation. All patients did systematic self-exposure homework and recorded this in a diary. Forty of these patients were followed-up two years later with self-ratings and ratings by interviewers blind to their treatment conditions. About two-thirds of the patients remained improved or much improved in their phobias, with no significant difference between any of the four treatment conditions. Spontaneous panics also remained improved. The absence of an imipramine effect may reflect the lack of initial dysphoria (anxiety–depression) in this sample compared with other studies where drug-effects have been found. The post-treatment superiority (evident at week 28) of patients who had therapist-aided exposure was no longer present at the two-year follow-up; the others had caught up, presumably because of their self-exposure homework.

Type
Research Article
Copyright
Copyright © 1984 The Royal College of Psychiatrists 

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