Trauma and defense style as response predictors of pharmacological treatment in panic patients.
BACKGROUND
As panic disorder (PD) has a chronic course, it is important to identify predictors that might be related to non-remission. The aim of this study is to verify whether history of trauma and defense style are predictors to pharmacological treatment response in PD patients.


METHODS
The sample was composed by 47 PD patients according to DSM-IV who were treated with sertraline for 16 weeks. Evaluations were assessed by the C.G.I. (Clinical Global Impression), the Hamilton-Anxiety Scale, the Hamilton-Depression Scale, the Panic Inventory and the DSQ-40 (Defense Style Questionnaire) at baseline and after treatment.


RESULTS
Full remission was observed in 61.7% of the sample. The predictors significantly associated with non-remission were: severity of PD (p=0.012), age of onset (p=0.02) and immature defenses (p=0.032). In addition, the history of trauma was associated with early onset of PD (p=0.043).


CONCLUSIONS
Panic patients had as predictors of worse response to pharmacological treatment the early onset and the severity of PD symptoms as well as the use of immature defenses at baseline. This finding corroborates the relevance of the evaluation of factors that might affect the response so as to enable the development of appropriate treatment for each patient.
Kipper
Letícia
L
Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos 2350, CEP: 90035-003, Porto Alegre, RS, Brazil.
Blaya
Carolina
C
Wachleski
Cláudia
C
Dornelles
Marina
M
Salum
Giovanni Abrahão
GA
Heldt
Elizeth
E
Manfro
Gisele G
GG
D000328:Adult; D002908:Chronic Disease; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000188:drug therapy*; D010552:Personality Assessment; D011379:Prognosis; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline