RESUMO
BACKGROUND: In Japan, cognitive behavioral therapy (CBT) for panic disorder (PD) is not well established. Therefore, a feasibility study of the clinical effectiveness and cost-effectiveness of CBT for PD in a Japanese clinical setting is urgently required. This was a pilot uncontrolled trial and the intervention consisted of a 16-week CBT program. The primary outcome was Panic Disorder Severity Scale (PDSS) scores. Quality of life was assessed using the EuroQol's EQ-5D questionnaire. Assessments were conducted at baseline, 8 weeks, and at the end of the study. Fifteen subjects completed outcome measures at all assessment points. RESULTS: At post-CBT, the mean reduction in PDSS scores from baseline was -6.6 (95 % CI 3.80 to -9.40, p < 0.001) with a Cohen's d = 1.77 (95 % CI 0.88-2.55). Ten (66.7 %) participants achieved a 40 % or greater reduction in PDSS. By calculating areas under the curve for EQ-5D index changes, we estimated that patients gained a minimum of 0.102 QALYs per 1 year due to the CBT. CONCLUSIONS: This study demonstrated that individual CBT for PD may be useful in Japanese clinical settings but further randomized control trials are needed. TRIAL REGISTRATION: UMIN-CTR UMIN000022693 (retrospectively registered).
Assuntos
Terapia Cognitivo-Comportamental/economia , Terapia Cognitivo-Comportamental/normas , Análise Custo-Benefício , Transtorno de Pânico/terapia , Adulto , Estudos de Viabilidade , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Projetos PilotoRESUMO
The public long-term care insurance program for the elderly in Japan set out in 2000 toward establishing a new system whereby citizens can be assured that they will receive care and be supported by the society as a whole. The insurance program includes computer-aided certification processes to estimate the needs for nursing care for clients. In this work, we show the applicability of an adaptive local nonlinear approximation method associated with the Japanese national database for automatic inference of the care class.