Zusammenfassung
Die Panikstörung mit Agoraphobie (PD/AG) führt bei den Betroffenen oft zu erheblichem Leiden und sozioökonomischen Folgen. Die kognitive Verhaltenstherapie (KVT) hat sich in einer Vielzahl von Studien in der Behandlung von PD/AG als wirksam erwiesen. Wenig bekannt ist welche spezifischen Wirkmechanismen der Effektivität dieser Therapieform zugrunde liegen. Im PANIC-NET wurde erstmalig in einer Mehrebenen-Untersuchung an 360 Patienten mit PD/AG eine multizentrische, randomisierte, kontrollierte Behandlungsstudie mit KVT angelegt. Es soll gezeigt werden, welche Therapieelemente (Exposition vs. kognitive Intervention) für den Behandlungserfolg verantwortlich sind. Außerdem wurde ein experimentelles Therapieverfahren mit einer zusätzlichen Gabe von D-Cycloserin erprobt. In einem integrativen Ansatz wurden parallel umfangreiche Untersuchungen zur Psychophysiologie, Bildgebung (3T-fMRT) und molekularen Genetik durchgeführt, um den Einfluss auf neurobiologische Mechanismen der Furchregulation zu untersuchen.
Abstract
Panic disorder with agoraphobia (PD/AG) is one of the most costly and disabling anxiety disorders with a large range of secondary mental health problems. According to numerous clinical trials, cognitive-behavioural therapy (CBT) represents the most effective psychotherapeutic intervention for PD/AG. Little is known about the exact mechanisms of CBT and their neurobiological effects on the fear network. Within the PANIC-NET a unique, large multilevel and multicenter reseach project was implemented. By carrying out a randomized controlled clinical trial, different CBT components (exposure vs. cognitive techniques) were investigated in 360 patients in order to identify the core active ingredients of CBT. Furthermore, experimental add-on therapy with D-Cycloserine was tested. In an integrated approach, fear-circuit mechanisms were investigated employing psychophysiological techniques, functional neuro-imaging using 3T-fMRI and molecular genetic approaches.
Key words
panic disorder - agoraphobia - cognitive-behavioral therapy - exposure - fear circuit
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Korrespondenzadresse
Prof. Dr. Volker Arolt
Klinik und Poliklinik für
Psychiatrie und Psychotherapie
Universitätsklinikum Münster
Albert Schweitzer Straße 11
48129 Münster
Email: arolt@uni-muenster.de