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. 2025 Feb 7;25(1):107.
doi: 10.1186/s12888-025-06527-7.

The bergen 4-day treatment for panic disorder: a longer-term follow-up

Thorstein Olsen Eide  1   2   3 , Bjarne Hansen  4   5 , Kay Morten Hjelle  4   5 , Stian Solem  5   6 , Michael G Wheaton  7 , Thröstur Björgvinsson  8 , Gerd Kvale  5   9 , Kristen Hagen  10   5   11
Affiliations

The bergen 4-day treatment for panic disorder: a longer-term follow-up

Thorstein Olsen Eide et al. BMC Psychiatry. .

Abstract

Introduction: Bergen 4-Day treatment (B4DT) is a form of concentrated exposure-based cognitive behavioral therapy (CBT) in which patients receive treatment over four consecutive days. Previous studies have shown B4DT to be a promising treatment format for panic disorder (PD), although the long-term stability of treatment gains requires additional study.

Aim: The aim of the current study was to evaluate the longer-term effectiveness of B4DT for patients with panic disorder with or without agoraphobia. This study extends a previously published study by providing a long-term follow-up of the same cohort (n = 30), initially assessed at three months post-treatment.

Method: Thirty patients with panic disorder were consecutively included in a retrospect open trial. The primary outcome measure was the Panic Disorder Severity Scale. The secondary outcome measures were the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9. Outcomes were assessed at pretreatment, posttreatment, 3-month follow-up, and longer-term follow-up (with a mean time of 18 months).

Results: There was a significant reduction in panic disorder symptoms from pretreatment to longer-term follow-up (d = 5.03, 95% CI [18.55, 21.12] to [1.33, 3.87]). The Panic Disorder Severity Scale (PDSS) mean decreased from 19.83 (SD = 0.64, 95% CI [18.55, 21.12]) before treatment, to 4.37 (SD = 0.64, 95% CI [2.98, 5.76]) post-treatment, followed by further decreases at the 3-month follow-up to a mean of 2.84 (SD = 0.64, 95% CI [1.45, 4.22]), and at the longer-term follow-up to 2.60 (SD = 0.64, 95% CI [1.33, 3.87]). There was no significant difference in symptom severity between the 3-month and 18-month assessments, indicating a sustained improvement (p <.001). At the 18-month follow-up, 90% of the patients were classified as being in remission. There were also significant reductions in symptoms of depression (d = 1.44) and generalized anxiety (d = 1.62) that were maintained at the longer-term follow-up assessment.

Conclusion: The results from the current study indicated that the treatment effects of B4DT are stable over time and that the treatment format appears to be promising for PD. Confirming these preliminary results in rigorous study designs is needed.

Trial registration: The study was approved by the Regional Committee for Medical and Health Research Ethics of Northern Norway (REK Nord-2021/209619).

Keywords: B4DT; CBT; Exposure; Intensive treatment; Panic disorder.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study underwent review by the Regional Committee for Medical Research Ethics Northern Norway, REK North (REK Nord-2021/209619) and received approval from the privacy officer at the institution. Written informed consent was obtained from all participants, who were informed about the voluntary nature of their participation and their right to withdraw from the study without any detrimental impact on their treatment. The research methods adhered to the appropriate guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

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