A randomised controlled feasibility study of brief cognitive therapy for the treatment of PANic Disorder in Adolescents (PANDA)

BACKGROUND: Panic disorder occurs in 1-3% of adolescents and without treatment often has a chronic course. Treatments need to be effective and efficient to be delivered in routine services. Given that a brief version of cognitive therapy has been shown to be effective in adults, an adapted version could be beneficial for adolescents with panic disorder. AIMS: We aimed to establish clinical and economic proof-of-concept for brief cognitive therapy for adolescent panic disorder and examine the feasibility of a future definitive trial compared with a brief generic form of CBT, using several well-defined criteria. METHOD: Thirty-four young people (aged 12-17 years) meeting diagnostic criteria for panic disorder and attending a routine clinical service, were randomly allocated to receive either brief cognitive therapy (B-CT) or a brief generic form of CBT; both involved five treatment sessions and up to two booster sessions and were delivered by Children's Wellbeing Practitioners. We examined patient outcomes, expectations, and experiences, as well as health economic factors post-treatment and at 3-month follow-up. We also explored panic severity 12 months after treatment completion. RESULTS: The trial met feasibility and acceptability criteria in relation to recruitment and there were no serious concerns around acceptability of treatment and trial procedures. CONCLUSIONS: This study provides preliminary evidence that both B-CT and a generic form of CBT are associated with positive outcomes, expectations, and experiences for adolescents, parents/carers and clinicians. However, there appear to be additional benefits from B-CT that are worthy of evaluation in a future definitive RCT.