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Clinical and psychosocial outcome of patients affected by panic disorder with or without agoraphobia: results from a naturalistic follow-up study

Published online by Cambridge University Press:  16 April 2020

Bernardo Carpiniello*
Affiliation:
Department of Public Health-Section of Psychiatry, University of Cagliari, Via Liguria, 13-09127Cagliari, Italy
Antonella Baita
Affiliation:
Department of Public Health-Section of Psychiatry, University of Cagliari, Via Liguria, 13-09127Cagliari, Italy
Mauro Giovanni Carta
Affiliation:
Department of Public Health-Section of Psychiatry, University of Cagliari, Via Liguria, 13-09127Cagliari, Italy
Rossella Sitzia
Affiliation:
Department of Public Health-Section of Psychiatry, University of Cagliari, Via Liguria, 13-09127Cagliari, Italy
Adolfo Maria Macciardi
Affiliation:
Department of Public Health-Section of Psychiatry, University of Cagliari, Via Liguria, 13-09127Cagliari, Italy
Stefano Murgia
Affiliation:
Department of Public Health-Section of Psychiatry, University of Cagliari, Via Liguria, 13-09127Cagliari, Italy
Alfredo Carlo Altamura
Affiliation:
Institute of Psychiatric Sciences, Hospital “C.Sacco”, University of Milan, Milan, Italy
*
*Corresponding author. E-mail address:bcarpini@iol.it (B. Carpiniello).
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Summary

Objective:

A clinical and psychosocial follow-up study of a cohort of 85 patients affected by panic disorder (PD) with or without agoraphobia was performed an average of 40 months after initial observation and following a mean duration of illness of 8 years.

Methods:

Eighty-five out of 130 patients affected by PDs with or without agoraphobia according to DSM-III R criteria, examined between 1990 and 1995 at an outpatient clinic were re-examined in 1997/1998 using the same standardized clinical evaluation performed on admission. Patients also underwent a structured diagnostic interview (Mini International Neuropsychiatric Interview, MINI) and psychosocial evaluation (Scale of Sheehan’s Disability Scale, DISS, Baker and Intagliata’s Satisfaction with Life Domains Scale, SLDS).

Results:

At follow-up, the percentage of patients who had either improved or were in remission was considerably higher among those initially diagnosed as PD with respect to those diagnosed as panic disorder with agoraphobia (PDA): Thirty-eight percent of PD and 20.6% of PDA patients were in clinical remission. Mild panic symptoms and phobic avoidance were found in the majority of patients who were still symptomatic (respectively 71% and 57%). Approximately 60% of patients reported a significant difficulty in performing daily activities and 40% expressed dissatisfaction in at least 50% of life domains considered. Seventy-two percent of subjects examined were still undergoing pharmacological treatment at the time of follow-up.

Conclusions:

The findings of the study are suggestive of a chronic illness with a significant impact on everyday quality of life of patients.

Type
Original article
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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References

Aaronson, T.A.Logue, C.M.On the longitudinal course of panic disorder: developmental history and predictors of phobic complications. Comp Psychiatry 1987;28:344355CrossRefGoogle Scholar
Angst, J.Panic disorder: history and epidemiology. Eur Psych 1995;10:57S59SCrossRefGoogle Scholar
Barlow, D.H.Long-term outcome for patients with panic disorder treated with cognitive-behavioral therapy. J Clin Psychiatry 1990;51((12 Suppl A))1723Google ScholarPubMed
Barlow, D.H.Gorman, J.M.Shear, M.K.Woods, S.W.Cognitive-behavioral therapy, imipramine or their combination for panic disorder: a randomized controlled trial. JAMA 2000;283 19:25732574CrossRefGoogle ScholarPubMed
Bonora, L.I.Conti, L.Piccinelli, L.et alMini International Neuropsychiatric Interview (Mini), versione italiana, Le scale di valutazione in Psichiatria. In: Conti, L.Digest Neuropsichiatria Milano: Utet 1995Google Scholar
Carpiniello, B.Baita, A.Rudas, N.Evaluating subjective quality of life among psychiatric patients. The Italian version of the satisfaction with life domain scale, Italian. J Psych Behav Sci 1997;2:7377Google Scholar
Carpiniello, B.Murgia, S.Baita, A.et alQualità di vita e disturbi dello spettro panico-agorafobico. Studi di Psichiatria 2000;2 1:3238Google Scholar
Conti, L.Dell'Osso, L.Cassano, G.B.Il sistema AMDP. Manuale per la valutazione e la Documentazione della Psicopatologia. Versione Italiana Milano: Mazzuchelli 1988Google Scholar
Conti, L.Disabiliy Scale (DISS), Versione Italiana, in Le scale di valutazione in Psichiatria. caratteristiche generali. In: Conti, L.Digest neuropsichiatria. Milano: Utet 1995Google Scholar
Faravelli, C.Albanesi, G.Agoraphobia with panic attacks: one-year prospective follow-up. Comprehen Psych 1987;28:481487CrossRefGoogle Scholar
Katschnig, H.D.Stolck, J.M.Klerman, G.L.Discontinuation and long-term follow-up of participants in a clinical drug trial for panic disorder. Biol Psych 1991;31:657660Google Scholar
Keller, M.B.Yonkers, K.A.Warshaw, M.G.et alRemission and relapse in subjects with panic disorder and panic with agoraphobia. A prospective short-interval naturalistic follow-up. J Nerv Ment Dis 1994;182:290296CrossRefGoogle ScholarPubMed
Lecrubier, Y.The impact of comorbidity on the treatment of panic disorder. J Clin Psychiatry 1998;59 Suppl 8 (6):1114Google ScholarPubMed
Lecrubier, Y.Judge, R.Long-term evaluation of paroxetine, clomipramine and placebo in panic disorder. Collaborative Paroxetine Panic Study Investigators. Acta Psych Scand 1997;95:153160CrossRefGoogle ScholarPubMed
Lecrubier, Y.Ustun, T.B.Panic and depression: a worldwide primary care perspective. J Clin Psychopharmacol 1998;13 Suppl 4 (6):S7S11Google ScholarPubMed
Lepola, U.M.Rimon, R.H.Riekkinen, P.J.Three-year follow-up of patients with panic disorder after short term treatment with alprazolam and imipramine. Int J Clin Psychopharmacol 1993;8:115118CrossRefGoogle ScholarPubMed
Lepola, U.M.Koponen, H.Leinonen, E.A naturalistic six-year follow-up study of patients with panic disorder. Acta Psych Scand 1996;3:181183CrossRefGoogle Scholar
Maier, W.Buller, R.One-year follow-up of panic disorder: outcome and prognostic factors. Eur Arch Psychiatr Neurol Sci 1988;238:105109Google ScholarPubMed
Noyes, R.Garvey, M.J.Cook, B.L.Follow-up study of patients with agoraphobia treated with trycyclics. J Aff Dis 1989;16:249257CrossRefGoogle Scholar
Noyes, R.Garvey, M.J.Cook, B.L.Samuleson, L.Problems with tricyclic antidepressant use in patients with panic disorder or agoraphobia. Results from a naturalistic follow-up study. J Clin Psych 1989;50:163169Google ScholarPubMed
Noyes, R.Reich, J.Christiansen, J.Outcome of panic disorder: relationship to diagnostic subtypes and comorbidity. Arch Gen Psych 1990;47:809818CrossRefGoogle ScholarPubMed
Pollock, M.H.Otto, M.W.Rosembaum, J.F.et alLongitudinal course of panic disorder: findings from the Massachussets general hospital naturalistic study. J Clin Psych 1990;51 12 Suppl A:1216Google Scholar
Rickels, K.Schweizer, E.Weiss, S.Zavodnick, S.Maintenance drug treatment for panic disorder. Short and long term outcome after drug taper. Arch Gen Psych 1993;50:6168CrossRefGoogle Scholar
Vollrath, M.Angst, J.Outcome of panic and depression in a seven-year follow-up: results of the Zurich study. Acta Psych Scand 1989;80:591596CrossRefGoogle Scholar
Weissman, M.M.Panic disorder: impact on quality of life. J Clin Psych 1991;51 Suppl 2:68Google Scholar
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