A 15-year follow-up study of patients with panic disorder.
BACKGROUND
Panic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms.


OBJECTIVE
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.


CONCLUSIONS
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.
Andersch
Sven
S
Department of Psychiatry, Institute of Clinical Neuroscience, Göteborg University, Gothenburg, Sweden. marie.i.lilja@vgregion.se
Hetta
Jerker
J
D000203:Activities of Daily Living / Q000523:psychology; D000379:Agoraphobia / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D000525:Alprazolam / Q000009:adverse effects / Q000627:therapeutic use*; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007099:Imipramine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D016584:Panic Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D012008:Recurrence; D019233:Retreatment; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012917:Social Adjustment; D012931:Social Environment; D016896:Treatment Outcome
D000525:Alprazolam; D014151:Anti-Anxiety Agents; D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D001569:Benzodiazepines; D007099:Imipramine; D017367:Selective Serotonin Reuptake Inhibitors