Blood-injury related phobic avoidance as predictor of nonresponse to pharmacotherapy in panic disorder with agoraphobia.
BACKGROUND
Several factors have been investigated as possible predictors of nonresponse to pharmacotherapy in Panic Disorder (PD) patients. In 1995 a study was published by Slaap et al. in this journal that found high Blood-Injury phobia scores on the Marks and Matthews Fear Questionnaire were predictive for a worse treatment-outcome for drug treatment in PD.


METHODS
The present paper describes a replication study with 61 PD patients, by means of a retrospective chart analysis, who were assessed at baseline and after 12 weeks of SSRI-treatment. Nonresponse was defined as still having panic attacks. Response was defined as absence of panic attacks and/or a reduction of at least 50% on the FQ Agoraphobia subscale.


RESULTS
Twenty (32%) patients were nonresponders. Nonresponders had a higher score on the FQ Blood-Injury subscale more often (55%) than responders (19.5%), significant at P=0.008. These results fully support the findings of Slaap et al. Implications of these findings are further discussed.


CONCLUSIONS
Limitations of this study are the retrospective design, and the absence of other psycho-physiological parameters of the specific blood-injury phobic complex.


CONCLUSIONS
However, it is tentatively concluded that the presence of comorbid blood-injury related phobic symptoms negatively affects treatment for panic disorder and agoraphobia.
Overbeek
Thea
T
Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands. thea.overbeek@pn.unimaas.nl
Büchold
Hagen
H
Schruers
Koen
K
Griez
Eric
E
D000328:Adult; D000379:Agoraphobia / Q000150:complications / Q000523:psychology*; D015897:Comorbidity; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy*; D010698:Phobic Disorders / Q000150:complications / Q000523:psychology*; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000523:psychology