Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder.
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.
Chavira
Denise A
DA
Department of Psychiatry, University of California, San Diego, CA 92037, USA. dchavira@ucsd.edu
Stein
Murray B
MB
Golinelli
Daniela
D
Sherbourne
Cathy D
CD
Craske
Michelle G
MG
Sullivan
Greer
G
Bystritsky
Alexander
A
Roy-Byrne
Peter P
PP
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
D014151:Anti-Anxiety Agents