2001 Volume 61 Issue 3 Pages 340-350
With the aim of elucidating factors relevant to the outcome, a 6-year follow-up study of panic disorder (PD) was performed. We studied one hundred patients with the Diagnostic and Statistical Manual for Mental Disorder, III-revised defined PD (37 men and 63 women, 39.5±13.6 years) as subjects who first visited the outpatient clinic of Showa University Hospital from September to December 1993 and participated in the 1-year follow-up study undertaken between October and December 1994. The present study was undertaken from April to May 2000. Written informed consent was obtained from those who were still undergoing treatment as outpatients. Furthermore, to those who discontinued their treatment, the aim of this study was explained by mail, thereafter, investigation was performed through a direct phone call for those whose informed consent was obtained. Factors such as frequency of panic attacks, severity of agoraphobic avoidance and anticipatory anxiety, drug compliance level, state of treatment and psychosocial stress level for the recent 3 months were subjected to analysis. A total of 57 cases, 6 undergoing treatment as outpatients and 51 corresponding through phone calls, participated in this study. Thirty-six cases (63.2%) suffered from more than one panic attack or limited symptom attacks, 38 (66.7%) experienced a certain degree of agoraphobic avoidance and 42 (73.7%) experienced anticipatory anxiety for the recent 3 months. Twenty-four cases (42.1%) were referred to psychiatric outpatient clinics, including our institute, 14 (24.6%) were treated by nonpsychiatrists, and out of the total, 41 cases (71.9%) were treated with drugs. These patients who experienced panic attacks or a moderate level of agoraphobic avoid ance/anticipatory anxiety were categorized as the poor outcome subgroup. Out of the 57 subjects, 25 (43.9%, 95%C.I.: 31.0-56.8%) were classified into the poor outcome subgroup. Logistic regression analysis using good/poor outcome as a dependent variable and sex, marital status, duration of illness, initial level of symptoms, characteristics rated by EPQ as independent variables, revealed that the poor outcome was predicted by marital status (not married), a strong sensation of shortness of breath or smothering and a mild sensation of palpitations, pounding heart, or accelerated heart rate.
