Clinical and psychosocial outcome of patients affected by panic disorder with or without agoraphobia: results from a naturalistic follow-up study.
OBJECTIVE
A clinical and psychosocial follow-up study of a cohort of 85 patients affected by panic disorder (PD) with or without agoraphobia was performed an average of 40 months after initial observation and following a mean duration of illness of 8 years.


METHODS
Eighty-five out of 130 patients affected by PDs with or without agoraphobia according to DSM-III R criteria, examined between 1990 and 1995 at an outpatient clinic were re-examined in 1997/1998 using the same standardized clinical evaluation performed on admission. Patients also underwent a structured diagnostic interview (Mini International Neuropsychiatric Interview, MINI) and psychosocial evaluation (Scale of Sheehan's Disability Scale, DISS, Baker and Intagliata's Satisfaction with Life Domains Scale, SLDS).


RESULTS
At follow-up, the percentage of patients who had either improved or were in remission was considerably higher among those initially diagnosed as PD with respect to those diagnosed as panic disorder with agoraphobia (PDA): Thirty-eight percent of PD and 20.6% of PDA patients were in clinical remission. Mild panic symptoms and phobic avoidance were found in the majority of patients who were still symptomatic (respectively 71% and 57%). Approximately 60% of patients reported a significant difficulty in performing daily activities and 40% expressed dissatisfaction in at least 50% of life domains considered. Seventy-two percent of subjects examined were still undergoing pharmacological treatment at the time of follow-up.


CONCLUSIONS
The findings of the study are suggestive of a chronic illness with a significant impact on everyday quality of life of patients.
Carpiniello
Bernardo
B
Department of Public Health-Section of Psychiatry, University of Cagliari, Via Liguria, 13-09127, Cagliari, Italy. bcarpini@iol.it
Baita
Antonella
A
Carta
Mauro Giovanni
MG
Sitzia
Rossella
R
Macciardi
Adolfo Maria
AM
Murgia
Stefano
S
Altamura
Alfredo Carlo
AC
D000328:Adult; D000379:Agoraphobia / Q000150:complications* / Q000175:diagnosis; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D011788:Quality of Life; D012074:Remission Induction; D012720:Severity of Illness Index