title: Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder.
abstract: This study's aim was to prospectively examine and identify a model of demographic, clinical, and attitudinal variables that impact improvement among patients with panic disorder. Subjects were 232 primary care patients meeting criteria for DSM-IV panic disorder. Eligible patients were randomly assigned to a collaborative care intervention or to treatment as usual. Assessments occurred at 3-month intervals during the course of 1 year. In final multivariate logistic regression models, patients with higher anxiety sensitivity and higher neuroticism scores at baseline were less likely to show clinical improvement (using a criterion of 20 or less on the Anxiety Sensitivity Index) at 3 months. Those who were non-white, had higher anxiety sensitivity, and higher overall phobic avoidance at baseline were less likely to show clinical improvement at 12 months. A greater understanding of these predictors may help clinicians identify who is at greatest risk for persistent panic-related symptoms and to plan the intensity of interventions accordingly.
authors.affiliation: Department of Psychiatry, University of California, San Diego, CA 92037, USA. dchavira@ucsd.edu
authors.forename: Denise A
authors.initials: DA
authors.lastname: Chavira
authors.forename: Murray B
authors.initials: MB
authors.lastname: Stein
authors.forename: Daniela
authors.initials: D
authors.lastname: Golinelli
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Sherbourne
authors.forename: Michelle G
authors.initials: MG
authors.lastname: Craske
authors.forename: Greer
authors.initials: G
authors.lastname: Sullivan
authors.forename: Alexander
authors.initials: A
authors.lastname: Bystritsky
authors.forename: Peter P
authors.initials: PP
authors.lastname: Roy-Byrne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D010552:Personality Assessment; D010698:Phobic Disorders / Q000453:epidemiology; D011320:Primary Health Care; D011336:Probability; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents