Sven Andersch1, Jerker Hetta. 1. Department of Psychiatry, Institute of Clinical Neuroscience, Göteborg University, Gothenburg, Sweden. marie.i.lilja@vgregion.se
Abstract
BACKGROUND:Panic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms. AIMS: To describe the long-term outcome of naturalistically treated PD. METHODS:Fifty-five outpatients with PD, who participated in aplacebo-controlled drug trial of the efficacy of alprazolam and imipramine15 years ago were reassessed with the same instruments used in the original study. RESULTS:Complete recovery (no panic attacks and no longer on medication during the last 10 years) was seen in 18% of patients, and an additional 13% recovered but were still on medication. Fifty-one percent experienced recurrent anxiety attacks whereas 18% still met diagnostic criteria for PD. The incidence of agoraphobia decreased from 69% to 20%. Patients with agoraphobia at admission tended to have a poorer long-term outcome according to daily functioning compared with patients without agoraphobia at admission, although both groups reported improved daily functioning at follow-up. Maintenance medication was common. No benzodiazepine abuse was reported. CONCLUSION: PD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.
RCT Entities:
BACKGROUND:Panic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms. AIMS: To describe the long-term outcome of naturalistically treated PD. METHODS: Fifty-five outpatients with PD, who participated in a placebo-controlled drug trial of the efficacy of alprazolam and imipramine 15 years ago were reassessed with the same instruments used in the original study. RESULTS: Complete recovery (no panic attacks and no longer on medication during the last 10 years) was seen in 18% of patients, and an additional 13% recovered but were still on medication. Fifty-one percent experienced recurrent anxiety attacks whereas 18% still met diagnostic criteria for PD. The incidence of agoraphobia decreased from 69% to 20%. Patients with agoraphobia at admission tended to have a poorer long-term outcome according to daily functioning compared with patients without agoraphobia at admission, although both groups reported improved daily functioning at follow-up. Maintenance medication was common. No benzodiazepine abuse was reported. CONCLUSION:PD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.
Authors: Steven E Bruce; Kimberly A Yonkers; Michael W Otto; Jane L Eisen; Risa B Weisberg; Maria Pagano; M Tracie Shea; Martin B Keller Journal: Am J Psychiatry Date: 2005-06 Impact factor: 18.112
Authors: Johanna Breilmann; Francesca Girlanda; Giuseppe Guaiana; Corrado Barbui; Andrea Cipriani; Mariasole Castellazzi; Irene Bighelli; Simon Jc Davies; Toshi A Furukawa; Markus Koesters Journal: Cochrane Database Syst Rev Date: 2019-03-28