Evidence map›Paper›PMID 29368665›Full record

SynthesisPsychological medicine2018

Dismantling cognitive-behaviour therapy for panic disorder: a systematic review and component network meta-analysis.

Alessandro Pompoli, Toshi A Furukawa, Orestis Efthimiou, Hissei Imai, Aran Tajika, Georgia Salanti

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Psychological medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Alessandro PompoliMD, Psychiatric Rehabilitation Clinic Villa San Pietro,Trento,Italy.
Toshi A FurukawaDepartments of Health Promotion and Human Behavior,Kyoto University Graduate School of Medicine/School of Public Health,Kyoto,Japan.
Orestis EfthimiouInstitute of Social and Preventive Medicine (ISPM), University of Bern,Bern,Switzerland.
Hissei ImaiDepartments of Health Promotion and Human Behavior,Kyoto University Graduate School of Medicine/School of Public Health,Kyoto,Japan.
Aran TajikaDepartments of Health Promotion and Human Behavior,Kyoto University Graduate School of Medicine/School of Public Health,Kyoto,Japan.
Georgia SalantiInstitute of Social and Preventive Medicine (ISPM), University of Bern,Bern,Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cognitive-behaviour therapy (CBT) for panic disorder may consist of different combinations of several therapeutic components such as relaxation, breathing retraining, cognitive restructuring, interoceptive exposure and/or in vivo exposure. It is therefore important both theoretically and clinically to examine whether specific components of CBT or their combinations are superior to others in the treatment of panic disorder. Component network meta-analysis (NMA) is an extension of standard NMA that can be used to disentangle the treatment effects of different components included in composite interventions. We searched MEDLINE, EMBASE, PsycINFO and Cochrane Central, with supplementary searches of reference lists and clinical trial registries, for all randomized controlled trials comparing different CBT-based psychological therapies for panic disorder with each other or with control interventions. We applied component NMA to disentangle the treatment effects of different components included in these interventions. After reviewing 2526 references, we included 72 studies with 4064 participants. Interoceptive exposure and face-to-face setting were associated with better treatment efficacy and acceptability. Muscle relaxation and virtual-reality exposure were associated with significantly lower efficacy. Components such as breathing retraining and in vivo exposure appeared to improve treatment acceptability while having small effects on efficacy. The comparison of the most v. the least efficacious combination, both of which may be provided as 'evidence-based CBT,' yielded an odds ratio for the remission of 7.69 (95% credible interval: 1.75 to 33.33). Effective CBT packages for panic disorder would include face-to-face and interoceptive exposure components, while excluding muscle relaxation and virtual-reality exposure.

Indexed as

Cognitive Behavioral TherapyHumansOutcome and Process Assessment, Health CarePanic DisorderCognitive-behaviour therapycomponent network meta-analysispanic disorders

Identifiers

PMID29368665
PMCPMC6137372

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.