Behavioural and Cognitive Psychotherapy

Research Article

Comparing Physical Exercise in Groups to Group Cognitive Behaviour Therapy for the Treatment of Panic Disorder in a Randomized Controlled Trial

Anders Hovlanda1 c1, Inger Hilde Nordhusa2, Trond Sjøbøa3, Bente A. Gjestada3, Birthe Birknesa3, Egil W. Martinsena4, Torbjørn Torsheima5 and Ståle Pallesena5

a1 University of Bergen, and Solli District Psychiatric Centre (DPS), Nesttun, Norway

a2 University of Bergen, Norway

a3 Solli District Psychiatric Centre (DPS), Nesttun, Norway

a4 University of Oslo, Norway

a5 University of Bergen, Norway


Background: Previous studies have suggested that physical exercise can reduce symptoms for subjects suffering from panic disorder (PD). The efficacy of this intervention has so far not been compared to an established psychotherapy, such as cognitive behaviour therapy (CBT). Assessment of controlled long-term effects and the clinical significance of the treatment are also lacking. Aim: To compare physical exercise to CBT as treatment for PD, and assess controlled long-term and clinically significant effects. Method: PD-patients were randomized to either three weekly sessions of physical exercise (n = 17), or one weekly session of CBT (n = 19). Both treatments ran for 12 weeks, were manualized and administered in groups. Patients were assessed twice before the start of treatment, at post-treatment and at 6 and 12 months thereafter. Primary outcome-measures consisted of the Mobility Inventory (MI), the Agoraphobia Cognitions Questionnaire (ACQ) and the Body Sensations Questionnaire (BSQ). Results: A two-way repeated measures MANOVA of these measures demonstrated a significant effect of time, F(16, 544) = 7.28, p < .01, as well as a significant interaction effect, F(16, 544) = 1.71, p < .05, in favour of CBT. This finding was supported by the assessment of clinically significant changes of avoidant behaviour and of treatment-seeking one year later. Conclusion: Group CBT is more effective than group physical exercise as treatment of panic disorder, both immediately following treatment and at follow-up assessments.

(Online publication July 05 2012)


  • Exercise;
  • cognitive behaviour therapy;
  • panic disorder;
  • anxiety


c1 Reprint requests to Anders Hovland, Department of Clinical Psychology, Christiesgt. 12, 5015 Bergen, Norway. E-mail:


  An Appendix is also available online in the table of contents for this issue: