title: Predictors of response among patients with panic disorder treated with medications in a naturalistic follow-up: the role of adult separation anxiety.
abstract: BACKGROUND
  Efficacy of treatments for panic disorder is well established, but not all patients respond. Adult separation anxiety has been found to predict poorer response to CBT, but its effect on response to medication has not been previously explored.
  
  
  OBJECTIVE
  The aim of this study is to investigate if panic-agoraphobic spectrum factors, including 'separation anxiety' factor predict treatment outcome in patients with panic disorder.
  
  
  METHODS
  Participants who met criteria for PD (n=57) completed baseline assessment and 12 months follow-up. Patients were administered the Panic Agoraphobic Spectrum Self-Report (PAS-SR, Lifetime and Last-Month Versions), and the Panic Disorder Severity Scale (PDSS). We examined patients who met the following criteria at baseline: 1) PDSS total score>7; 2) no current Axis I comorbidity with major depression; 3) no lifetime or current bipolar disorder. All patients were treated with evidence-based psychopharmacological treatment for panic disorder during the 12-month observation period.
  
  
  RESULTS
  Twenty eight patients (48.1%) achieved remission during the follow-up period. In a logistic regression model, controlling for baseline severity, gender and age, only the last-month PAS-SR 'separation anxiety' factor was associated with a lower likelihood of remission.
  
  
  CONCLUSIONS
  Signs and symptoms of separation anxiety in adulthood, as assessed with the PAS-SR Last Month version, are predictors of poor treatment outcome in patients with PD. We submit that the assessment of panic-agoraphobic spectrum features, including adult separation anxiety, should become routine of clinical assessment of patients with PD. It is likely that a better psychopathological characterization of patients may inform treatment selection, and result in better treatment outcome.
authors: Department of Psychiatry, Neurobiology, Pharmacology, Biotechnology, University of Pisa, Pisa, Italy.
authors: M
authors: M
authors: Miniati
authors: S
authors: S
authors: Calugi
authors: P
authors: P
authors: Rucci
authors: M K
authors: MK
authors: Shear
authors: A
authors: A
authors: Benvenuti
authors: D
authors: D
authors: Santoro
authors: M
authors: M
authors: Mauri
authors: G B
authors: GB
authors: Cassano
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000150:complications / Q000188:drug therapy*; D001010:Anxiety, Separation / Q000150:complications*; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000188:drug therapy*; D011379:Prognosis; D012074:Remission Induction; D016896:Treatment Outcome