The long-term course of panic disorder--an 11 year follow-up.
BACKGROUND
The purpose of this study was to assess the naturalistic long-term course of panic disorder over a period of 11 years.


METHODS
Thirty DSM-III-R panic disorder patients, who had suffered from panic disorder for 6 years on average and who had taken part in an 8-week multicenter drug trial, were included in the intent-to-follow-up group to be reinterviewed 11 years after the end of the trial. At baseline and at follow-up the same instruments were used to assess frequency of panic attacks, level of phobic avoidance, and disabilities. Treatments received during the follow-up period and attempted suicides were assessed with a structured interview. Periods of well-being during the follow-up period were elicited retrospectively with a specifically designed longitudinal chart.


RESULTS
Twenty-four patients could actually be reinterviewed after 11.3 years. While at baseline all patients had suffered from panic attacks and had been severely disabled on a number of measures, 66.7% had no panic attack during the year before follow-up. During the month before follow-up 87.5% had no panic attack, and 54% showed no or only mild phobic avoidance. In the areas of work and family life 90% showed no or only mild disabilities, whereas in the area of social life this percentage was lower (67%). Thirty-three percent of the patients were completely remitted according to a composite remission criterion.


CONCLUSIONS
Panic disorder is not a uniformly chronic and progressing disorder. Over a period of 11 years there is a good chance of recovery from panic attacks and disabilities, and full remission is also possible.
Swoboda
Hemma
H
Department of Psychiatry, Section of Social Psychiatry and Evaluative Research, University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. hemma.swoboda@univie.ac.at
Amering
M
M
Windhaber
J
J
Katschnig
H
H
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D001315:Australia; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000534:rehabilitation*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome