Long-term follow-up after a drug trial for panic disorder.
BACKGROUND
This study investigates the naturalistic course of panic disorder over four years and attempts to identify predictors for outcome.


METHODS
423 DSM-III-R panic disorder patients who had taken part in an international multicentre drug trial were selected for follow-up; we were able to re-interview 367 (87%). For panic attacks, phobic avoidance and disabilities the same rating scales were administered as had been used for the clinical trials.


RESULTS
While 61% of all patients experienced at least occasional panic attacks at follow-up, few suffered from serious phobic avoidance (16.7%) or serious disabilities (work 7.9%); family 8.7%; social 13.9%). Panic attack frequency at baseline, original trial medication and continuous use of psychotropic medication during follow-up are not related to outcome, whereas longer duration of illness and more severe phobic avoidance at baseline are unfavourable.


CONCLUSIONS
The course of panic disorder is not uniform. Since long duration of illness and severe phobic avoidance at baseline are predictors for an unfavourable outcome, more rigorous efforts should be undertaken to detect and treat panic disorder at an early stage.
Katschnig
H
H
Department of Psychiatry, University of Vienna, Austria.
Amering
M
M
Stolk
J M
JM
Klerman
G L
GL
Ballenger
J C
JC
Briggs
A
A
Buller
R
R
Cassano
G
G
Garvey
M
M
Roth
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000525:Alprazolam / Q000008:administration & dosage* / Q000009:adverse effects; D014151:Anti-Anxiety Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine; D000525:Alprazolam