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Un estudio de seguimiento de 15 años de pacientes con trastorno de angustia

Published online by Cambridge University Press:  12 May 2020

Sven Andersch
Affiliation:
Departamento de Psiquiatría, Instituto de Neurociencia Clínica, Universidad de Goteborg, Gothenburg, Suecia
Jerker Hetta
Affiliation:
Departamento de Psiquiatría, Instituto de Neurociencia Clínica, Universidad de Goteborg, Gothenburg, Suecia
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Resumen

Antecedentes.

El trastorno de angustia (TA) se considera por lo general como un trastorno crónico con variación considerable en la gravedad de los síntomas.

Propósitos.

Describir la evolución a largo plazo del TA tratado de manera naturalista.

Métodos.

Cincuenta y cinco pacientes ambulatorios con TA que habían participado en un ensayo farmacológico controlado con placebo de la eficacia del alprazolam y la imipramina hacía 15 años tuvieron otra evaluación con los mismos instrumentos utilizados en el estudio original.

Resultados.

Se vio recuperación completa (ausencia de crisis de angustia y llevar los 10 últimos años sin tomar medicación) en el 18% de los pacientes, y otro 13% se recuperó pero estaba todavía con medicación. El cincuenta y uno por ciento experimentaba crisis de ansiedad recurrentes, mientras que el 18% cumplía todavía los criterios diagnósticos para el TA. La incidencia de agorafobia disminuyó del 69% al 20%. Los pacientes con agorafobia en la admisión tendían a tener una evolución a largo plazo peor según el funcionamiento diario, comparado con los pacientes sin agorafobia en la admisión, aunque ambos grupos comunicaron mejoría del funcionamiento diario en el seguimiento. La medicación de mantenimiento era común. No se informó de abuso de benzodiacepinas.

Conclusión.

El TA tiene una evolución favorable en una proporción sustancial de pacientes. Sin embargo, la enfermedad es crónica y precisa tratamiento. El tratamiento a corto plazo dado en el ensayo farmacológico no tuvo influencia en la evolución a largo plazo.

Type
Artículo original
Copyright
Copyright © European Psychiatric Association 2004

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