Cognitive and Guided Mastery Therapies for Panic Disorder with Agoraphobia: 18-Year Long-Term Outcome and Predictors of Long-Term Change

2014 ◽  
Vol 23 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Asle Hoffart ◽  
Liv M. Hedley ◽  
Karol Svanøe ◽  
Harold Sexton
Keyword(s):  
Panic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Term Change ◽  
Guided Mastery

scholarly journals Thirty-year outcome of anxiety and depressive disorders and personality status: comprehensive evaluation of mixed symptoms and the general neurotic syndrome in the follow-up of a randomised controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Peter Tyrer ◽  
Helen Tyrer ◽  
Tony Johnson ◽  
Min Yang
Keyword(s):  
Randomised Controlled Trial ◽  
Panic Disorder ◽  
Controlled Trial ◽  
Anxiety And Depression ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Personality Dysfunction ◽  
Randomised Controlled ◽  
Anxiety Depression

Abstract Background Cohort studies of the long-term outcome of anxiety, depression and personality status rarely join together. Methods Two hundred and ten patients recruited with anxiety and depression to a randomised controlled trial between 1983 and 1987 (Nottingham Study of Neurotic Disorder) were followed up over 30 years. At trial entry personality status was assessed, together with the general neurotic syndrome, a combined diagnosis of mixed anxiety–depression (cothymia) linked to neurotic personality traits. Personality assessment used a procedure allowing conversion of data to the ICD-11 severity classification of personality disorder. After the original trial, seven further assessments were made. Observer and self-ratings of psychopathology and global outcome were also made. The primary outcome at 30 years was the proportion of those with no Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis. Data were analysed using multilevel repeated measures models that adjusted for age and gender. Missing data were assumed to be missing at random, and the models allowed all subjects to be included in the analysis with missing data automatically handled in the model estimation. Results At 30 years, 69% of those with a baseline diagnosis of panic disorder had no DSM diagnosis compared to 37–47% of those with generalised anxiety disorder, dysthymia or mixed symptoms (cothymia) (p = 0.027). Apart from those with no personality dysfunction at entry all patients had worse outcomes after 30 years with regard to total psychopathology, anxiety and depression, social function and global outcome. Conclusions The long-term outcome of disorders formerly called ‘neurotic’ is poor with the exception of panic disorder. Personality dysfunction accentuates poor recovery.

Long-term outcome of patients with dysthymia and panic disorder: A naturalistic 9-year follow-up study

2008 ◽  
Vol 62 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Cecilia Svanborg ◽  
Anna Åberg Wistedt ◽  
Pär Svanborg
Keyword(s):  
Panic Disorder ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Follow Up Study

A 15-year follow-up study of patients with panic disorder

2003 ◽  
Vol 18 (8) ◽  
pp. 401-408 ◽  
Author(s):  
Sven Andersch ◽  
Jerker Hetta
Keyword(s):  
Panic Disorder ◽  
Favourable Outcome ◽  
Drug Trial ◽  
Panic Attacks ◽  
Daily Functioning ◽  
Short Term Treatment ◽  
Term Outcome ◽  
Long Term Outcome

AbstractBackgroundPanic disorder (PD) is generally regarded as a chronic condition with considerable variation in severity of symptoms.AimsTo describe the long-term outcome of naturalistically treated PD.MethodsFifty-five outpatients with PD, who participated in a placebo-controlled drug trial of the efficacy of alprazolam and imipramine 15 years ago were reassessed with the same instruments used in the original study.ResultsComplete recovery (no panic attacks and no longer on medication during the last 10 years) was seen in 18% of patients, and an additional 13% recovered but were still on medication. Fifty-one percent experienced recurrent anxiety attacks whereas 18% still met diagnostic criteria for PD. The incidence of agoraphobia decreased from 69% to 20%. Patients with agoraphobia at admission tended to have a poorer long-term outcome according to daily functioning compared with patients without agoraphobia at admission, although both groups reported improved daily functioning at follow-up. Maintenance medication was common. No benzodiazepine abuse was reported.ConclusionPD has a favourable outcome in a substantial proportion of patients. However, the illness is chronic and needs treatment. The short-term treatment given in the drug trial had no influence on the long-term outcome.

The Galway Study of Panic Disorder III

1996 ◽  
Vol 168 (4) ◽  
pp. 462-469 ◽  
Author(s):  
D. O'rourke ◽  
T. J. Fahy ◽  
J. Brophy ◽  
P. Prescott
Keyword(s):  
Panic Disorder ◽  
Controlled Trial ◽  
Clinical Status ◽  
Complete Recovery ◽  
Acute Stage ◽  
Severe Illness ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Research Interview

BackgroundThe aim was to evaluate long-term outcome of DSM–III–R panic disorder at a mean of 5.3 years following a controlled trial of treatment that included antidepressants and behavioural counselling.MethodSixty-eight (86%) subjects were evaluated by lengthy research interview.ResultsThirty-four per cent recovered and remained well, 46% were minimally impaired and 20% had persistent panic disorder of whom half remained significantly impaired. Anxious–fearful personality dysfunction was the most important predictor of poor outcome, followed by poor clinical status at discharge and inability at baseline to recall vividly the initial panic attack. Those who dropped out from the original trial did badly.ConclusionsComplete recovery can occur even after many years of severe illness in a large minority of subjects who receive both antidepressants and behavioural counselling in the acute stage of treatment. The comparative prognostic value of personality, severity and chronicity need to be more fully addressed in future studies.

Long-Term Outcome of Panic Disorder and Social Phobia

1998 ◽  
Vol 12 (4) ◽  
pp. 395-406 ◽  
Author(s):  
Caroline Hunt ◽  
Gavin Andrews
Keyword(s):  
Panic Disorder ◽  
Social Phobia ◽  
Term Outcome ◽  
Long Term Outcome

The Galway Study of Panic Disorder IV

1996 ◽  
Vol 169 (1) ◽  
pp. 98-100
Author(s):  
D. O'Rourke ◽  
T. J. Fahy ◽  
P. Prescott
Keyword(s):  
Panic Disorder ◽  
Clinical Entity ◽  
Outcome Study ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Syndrome Diagnosis ◽  
Patient Change ◽  
State Examination

BackgroundA long-term outcome study of DSM–III–R panic disorder included the Present State Examination (PSE) at baseline and follow up five to six years later.MethodPSE test–retest and individual within-patient change scores on various PSE syndromes were assessed for consistency with either a categorical view of panic disorder as a stable clinical entity or panic disorder as one facet only of a ‘general neurotic syndrome’.ResultsPSE profile at baseline was virtually identical with that at follow up. Few patients had ‘changed’ in PSE syndrome diagnosis after five to six years.ConclusionThese data, although not conclusive, are supportive of the concept of DSM–III–R panic disorder as a stable clinical entity and are correspondingly difficult to reconcile with the view that panic disorder is but one facet only of a general neurotic syndrome.

Long-term outcome of panic disorder with agoraphobia treated by exposure

2001 ◽  
Vol 31 (5) ◽  
pp. 891-898 ◽  
Author(s):  
G. A. FAVA ◽  
C. RAFANELLI ◽  
S. GRANDI ◽  
S. CONTI ◽  
C. RUINI ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Antidepressant Drugs ◽  
Panic Attacks ◽  
Consecutive Series ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Concurrent Use ◽  
Pre Treatment

Background. There is a paucity of long-term outcome studies of panic disorder that exceed a 2-year follow-up. The aim of the study was to evaluate the long-term follow-up of patients with panic disorder with agoraphobia treated according to a standardized protocol.Methods. A consecutive series of 200 patients satisfying the DSM-IV criteria for panic disorder with agoraphobia was treated in an out-patient clinic with behavioural methods based on exposure homework. One hundred and thirty-six patients became panic free after 12 sessions of psychotherapy and 132 were available for follow-up. A 2- to 14-year (median = 8 years) follow-up was performed. Survival analysis was employed to characterize the clinical course of patients.Results. Thirty-one of the 132 patients (23%) had a relapse of panic disorder at some time during follow-up. The estimated cumulative percentage of patients remaining in remission was 93·1 after 2 years, 82·4 after 5 years, 78·8 after 7 years and 62·1 after 10 years. Such probabilities increased with younger age, and in the absence of a personality disorder, of high pre-treatment levels of depressed mood, of residual agoraphobic avoidance after exposure, and of concurrent use of benzodiazepines and antidepressant drugs.Conclusions. The findings suggest that exposure treatment can provide lasting relief to the majority of patients with panic disorder and agoraphobia. Disappearance of residual and subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy.

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