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Given the difficulty in accessing professional cognitive behavioral therapy in real-world clinical settings, pharmacotherapy remains the typical treatment in patients with panic disorder. However, some patients with panic disorder remain symptomatic despite pharmacotherapy. In this study, to highlight next-step treatment options for patients with panic disorder, we aimed to assess the efficacy of videoconference-based cognitive behavioral therapy for patients with panic disorder who remained symptomatic despite initial pharmacological treatment. To this end, we evaluated the effectiveness of videoconference-based cognitive behavioral therapy for patients as an adjunct to usual care.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Symptomatic patients with panic disorder following primary pharmacotherapy were randomly assigned to videoconference-based cognitive behavioral therapy or usual care-only groups. The primary outcomes were a reduction in symptomatology assessed at 8 and 16 weeks, using the Panic Disorder Severity Scale. We calculated the 95% confidence intervals (CIs) of the mean with an unknown variance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Thirty participants were included in this study. After 16 weeks, the adjusted mean changes in Panic Disorder Severity Scale score from baseline were \u2212\u20097.92 and 0.75 in the videoconference-based cognitive behavioral therapy (<jats:italic>n<\/jats:italic>\u2009=\u200915) and usual care (<jats:italic>n<\/jats:italic>\u2009=\u200915) groups, respectively, with a between-group difference of \u2212\u20098.67 (95% CI: \u221211.80 to \u2212\u20095.54; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). A considerable proportion of patients in the videoconference-based cognitive behavioral therapy group achieved a positive response at week 16 (80% vs. 6.7%; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and demonstrated a higher remission rate (66.7% vs. 0.0%; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) than that in the usual care group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Thus, videoconference-based cognitive behavioral therapy is an effective treatment for patients with panic disorder who remain symptomatic following pharmacotherapy. The results suggest that videoconference-based cognitive behavioral therapy, which can be used at home, may be effective for patients with panic disorder or chronic panic disorder who have difficulty accessing cognitive behavioral therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>The study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029987) on Nov 20, 2017.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12888-025-07320-2","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T18:55:57Z","timestamp":1758740157000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Videoconference-delivered cognitive behavioral therapy in patients with symptomatic panic disorder following primary pharmacotherapy: a randomized, assessor-blinded, controlled trial"],"prefix":"10.1186","volume":"25","author":[{"given":"Yoichi","family":"Seki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Takemura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chihiro","family":"Sutoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Remi","family":"Noguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoko","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ikuyo","family":"Ohira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinobu","family":"Nagata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"7320_CR1","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1002\/mpr.1359","volume":"21","author":"RC Kessler","year":"2012","unstructured":"Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen H-U. 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