127. Lifestyle modification for panic disorder treatment: a three-year cohort study through wearable monitoring, AI, and case management system

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Abstract Background Panic disorder (PD) is a recurrent and often debilitating anxiety condition characterized by sudden episodes of intense fear and physiological arousal. Despite the availability of pharmacological and psychotherapeutic treatments, many individuals continue to experience persistent symptoms, low treatment adherence, and high relapse rates after initial improvement. Traditional face-to-face care models frequently face limitations in continuity and accessibility, especially during the maintenance phase of treatment when ongoing monitoring and support are critical to preventing relapse. In recent years, mobile health (mHealth) interventions have emerged as promising adjunctive tools for mental health management. These interventions enable continuous patient engagement, self-monitoring, and communication with clinicians. However, the effectiveness of mobile-aided case management programs specifically targeting panic disorder remains insufficiently studied. Aims & Objectives This study aims to examine the clinical impact of a mobile-aided case management program designed to enhance continuity of care for individuals with panic disorder. The primary objective is to determine whether integrating mobile-based support into standard psychiatric care can reduce panic symptom severity, improve treatment adherence, and enhance patients’ perceived quality of care. Secondary objectives include exploring participants’ subjective experiences, such as self-awareness, emotional regulation, and perceived interpersonal support throughout the intervention period. Method A three-year cohort study was conducted involving 138 adults diagnosed with panic disorder according to DSM-5 criteria. Participants were divided into two groups: a mobile-aided case management (MACM) group (n = 108) and a treatment-as-usual (TAU) group (n = 30). The MACM program consisted of a smartphone application integrated with a clinical case management system, enabling real-time symptom tracking, psychoeducation, scheduled check-ins, and secure clinician messaging. Data collection occurred at baseline and at 3-, 6-, and 12-month follow-up points. A mixed-methods approach was applied, combining quantitative self-report scales (e.g., Panic Disorder Severity Scale, State-Trait Anxiety Inventory) with qualitative data from in-depth interviews, behavioral observations, and electronic medical record analysis. Results The MACM group demonstrated significantly greater reductions in both panic severity (p = 0.008) and state anxiety levels (p = 0.016) compared to the TAU group at the 6-month checkpoint, particularly during the maintenance phase of treatment. Beyond symptom reduction, participants reported increased self-awareness of panic triggers, improved confidence in coping skills, and strengthened therapeutic alliances through ongoing communication with case managers. Qualitative analyses indicated that the mobile-assisted approach enhanced patients’ sense of control, accountability, and continuity of care, contributing to sustained engagement and lower relapse risk. Discussion & Conclusions The findings suggest that mobile-aided case management serves as an effective adjunct to conventional treatment for panic disorder. By extending therapeutic contact beyond clinical settings, it supports sustained recovery, reduces symptom recurrence, and enhances patients’ overall treatment experience. Future research should investigate long-term cost-effectiveness, integration with other digital therapeutics, and adaptability to broader anxiety spectrum disorders

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