title: Development and validation of a risk-prediction algorithm for the recurrence of panic disorder.
abstract: BACKGROUND
  To develop and validate a risk prediction algorithm for the recurrence of panic disorder.
  
  
  METHODS
  Three-year longitudinal data were taken from the National Epidemiologic Survey on Alcohol and Related Conditions (2001/2002-2004/2005). One thousand six hundred and eighty one participants with a lifetime panic disorder and who had not had panic attacks for at least 2 months at baseline were included. The development cohort included 949 participants; 732 from different census regions were in the validation cohort. Recurrence of panic disorder over the follow-up period was assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule, based on the DSM-IV criteria. Logistic regression was used for deriving the algorithm. Discrimination and calibration were assessed in the development and the validation cohorts.
  
  
  RESULTS
  The developed algorithm consisted of 11 predictors: age, sex, panic disorder in the past 12 months, nicotine dependence, rapid heartbeat/tachycardia, taking medication for panic attacks, feelings of choking and persistent worry about having another panic attack, two personality traits, and childhood trauma. The algorithm had good discriminative power (C statistic = 0.7863, 95% CI: 0.7487, 0.8240). The C statistic was 0.7283 (95% CI: 0.6889, 0.7764) in the external validation data set.
  
  
  CONCLUSIONS
  The developed risk algorithm for predicting the recurrence of panic disorder has good discrimination and excellent calibration. Data related to the predictors can be easily attainable in routine clinical practice. It can be used by clinicians to calculate the probability of recurrence of panic disorder in the next 3 years for individual patients, communicate with patients regarding personal risks, and thus improve personalized treatment approaches.
authors.affiliation: Faculty of Medicine, Department of Psychiatry, University of Calgary, Calgary, Canada; Faculty of Medicine, Department of Community Health Sciences, University of Calgary, Calgary, Canada.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Jitender
authors.initials: J
authors.lastname: Sareen
authors.forename: James
authors.initials: J
authors.lastname: Bolton
authors.forename: JianLi
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D000465:Algorithms; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic / Q000379:methods / Q000592:standards*; D008137:Longitudinal Studies; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000523:psychology*; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors
keywords: panic disorder; recurrence; risk prediction