Internet-Based Cognitive Behavioral Therapy for Panic Disorder Among Arabic-Speaking Patients: Case Series

Background Internet-based cognitive behavioral therapy (ICBT) has shown promise for the treatment of panic disorder (PD), but little is known about its feasibility and use across cultures and languages. Objective This study examines the feasibility and preliminary outcomes of an Arabic-translated ICBT program for PD and describes how patients experienced the program. Methods Six Arabic-speaking women (aged 21‐50 years, mean 35, SD 10 years) with a primary diagnosis of PD underwent a 16-week guided ICBT program using an Arabic-translated protocol. PD symptoms (Panic Disorder Severity Scale–Self-Report [PDSS-SR]), anxiety sensitivity (Anxiety Sensitivity Index-3 [ASI-3]), and agoraphobic avoidance (Mobility Inventory [MI]) were assessed pretreatment, posttreatment, and 3 months later. The outcomes were analyzed descriptively. Four patients also participated in individual, semistructured posttreatment interviews about their experience of the program, which are reported descriptively as the patient-perspective component of the case series. Results The program was completed by 4 of the 6 (67%) patients. Among completers, PDSS-SR scores decreased from 11‐18 pretreatment to 0‐7 posttreatment, ASI-3 scores decreased from 18‐59 to 0‐4, and MI scores decreased from 1.44‐3.82 to 0.00‐1.60, indicating reduced agoraphobic avoidance. Follow-up data were available for 3 of the 4 (75%) completers: 2 maintained their gains, and 1 showed a partial return of symptoms. The fourth reported a recurrence of symptoms posttreatment but could not be reached for follow-up. During the interviews, all 4 patients expressed positive views of the program. Conclusions Arabic-translated ICBT appeared feasible and was associated with reductions in panic symptoms and anxiety sensitivity among Arabic-speaking patients with mild-to-moderate PD. These preliminary findings support further investigation with larger samples.