Predictors of short- and long-term avoidance in completers of inpatient group interventions for agoraphobia.
BACKGROUND
Little is currently known about predictors of follow-up outcome of psychological treatment of agoraphobia. In this study, we wished to examine predictors of short- and long-term avoidance after inpatient group interventions for agoraphobia.


METHODS
Ninety-six (68%) of 141 agoraphobic patients (74% women) who had completed treatment in two open and one randomized controlled trial (RCT) were followed up 13 to 21 years after start of treatment.


RESULTS
Major depression at pre-treatment predicted less short-term (up to one year after end of treatment) improvement in agoraphobic avoidance. Working and being married/cohabiting at pre-treatment predicted greater long-term (across one-year, two-year, and 13-21 years follow-up) improvement. In contrast, the duration of agoraphobia, amount of Axis I and II co-morbidity, being diagnosed with avoidant, dependent, and obsessive-compulsive personality disorder, and the use of antidepressants and benzodiazepines the month before intake to treatment, were unrelated to short-term as well as long-term outcome.


CONCLUSIONS
As many as 31.9% of the included patients did not attend long-term follow-up and the power of the study was limited. The long time period between the two and 13-21 year follow-ups is a limitation, in which it is difficult to assess what actually happened. Although all the patients received some form of CBT, there was variability among the treatments.


CONCLUSIONS
The only short-term predictor identified represented a clinical feature, whereas the long-term predictors represented features of the patients' life situation. The limited power of the study precludes the inference that non-significant predictors are unrelated to follow-up outcome.
Research Institute, Modum Bad, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, PB 1094, Blindern, N-0317 Oslo, Norway. Electronic address: asle.hoffart@modum-bad.no.
Asle
A
Hoffart
Research Institute, Modum Bad, N-3370 Vikersund, Norway; Department of Psychology, University of Oslo, PB 1094, Blindern, N-0317 Oslo, Norway.
Tuva
T
Øktedalen
Buskerud and Vestfold University College, PB 2243, N-3103 Tønsberg, Norway.
Karol
K
Svanøe
Research Institute, Modum Bad, N-3370 Vikersund, Norway.
Liv M
LM
Hedley
Research Institute, Modum Bad, N-3370 Vikersund, Norway.
Harold
H
Sexton
D000328:Adult; D000379:Agoraphobia / Q000523:psychology* / Q000628:therapy; D001362:Avoidance Learning; D002986:Clinical Trials as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011615:Psychotherapy, Group; D012307:Risk Factors; D016896:Treatment Outcome
Agoraphobia; Latent growth curve modeling; Long term follow-up; Psychological treatment