Prospective follow-up study lasting 2 years in patients with panic disorder with and without depressive disorders

Abstract

A group of 52 patients presenting at an outpatient unit for anxiety disorders were included consecutively in a prospective 2-year follow-up study. Patients were administered to a structured interview for DSM-III-R diagnoses, a follow-up interview (LIFE), and various other ratings. Sociodemographic and illness-history characteristics, levels of anxiety and depressive symptoms, as well as psychosocial impairment, were evaluated at baseline and follow-up and compared between patients with panic disorder only and patients with panic disorder and concomitant depressive disorders at index assessment. Cross-sectional and longitudinal differences between patients with panic disorder only and patients with panic disorder and concomitant depression have been found, indicating that patients with comorbid conditions are more severely ill and have a less favorable outcome. For the total sample, however, the 2-year outcome was better than that reported in many other follow-up studies.

Management of anxiety disorders: The added challenge of comorbidity

“…When patients suffer from both panic disorder and depression, the clinical presentation of both disorders is more severe [Andrade et al, 1994;Vollrath et al, 1990;Brown et al, 1996a;Grunhaus et al, 1994;Reich et al, 1993] and there is a heavier burden of disability, for example, more impairment of daily activities [Scheibe and Albus, 1994] than experienced by patients with either panic disorder or depression alone. Comorbid depression has a detrimental effect on the course and outcome of panic disorder [van Valkenburg et al, 1984;Scheibe and Albus, 1994]; patients take longer to respond to treatment and are less likely to obtain full remission of their symptoms.…”

“…Comorbid depression has a detrimental effect on the course and outcome of panic disorder [van Valkenburg et al, 1984;Scheibe and Albus, 1994]; patients take longer to respond to treatment and are less likely to obtain full remission of their symptoms.…”

Australian and New Zealand clinical practice guidelines for the treatment of panic disorder and agoraphobia

“…Clinical studies indicate that the rate of major depression may be higher than 30%[14,33,34]. Panic disorder occurring only in the context of depression is excluded by the criteria (see DSM‐IV), but having concurrent depression can result in a poorer response to treatment [34−40]. A history of other anxiety disorders is also common, particularly social phobia (21%), generalized anxiety disorder (56%) and OCD (24%) [9,41].…”

The Concept of Recovery in Affective Disorders

“…29, 100. 103-106] and anxiety [76,81,82,89,106] disorders as to relapse and recurrence rates seems to 6 Psychother Psvchosom 1996:65:2-13…”

“…Medication discontinuation, whether it involves alprazo lam or imipramine, appears to result in relapse of panic in a high proportion of patients, whereas behavioral treat ment of panic disorder was found to yield long-term bene fits [77]. Regardless of the type of treatment involved and despite achievement of clinical remission, residual symp toms were found to be extremely common [76][77][78][79][80][81][82], Resid ual symptoms encompassed phobic and anxiety distur bances, social impairment and dependence. In one study [81] only 13% of patients were completely free of symp toms at follow-up.…”