Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-28T19:51:03.276Z Has data issue: false hasContentIssue false

Residual symptoms and comorbidity in panic disorder

Published online by Cambridge University Press:  16 April 2020

Antoni Corominas*
Affiliation:
Chair of the Department of Psychiatry, Hospital de Mollet, Cristòfol Colom, 1, 08100Mollet, Barcelona, Spain
Tina Guerrero
Affiliation:
Department of Psychiatry, Psychopharmacology and mental health, Pharma Research, Barcelona, Spain
Julio Vallejo
Affiliation:
Chair of the Department of Psychiatry, Hospital de Bellvitge “Princeps d’Espanya”, L’Hospitalet de Llobregat, Barcelona, Spain
*
*Corresponding author. E-mail address:[email protected] (A. Corominas).
Get access

Summary

Background

The aim of this study was to assess the outcome of the comorbid conditions of panic disorder after 1 year of treatment, emphasizing the detection of residual symptoms and their relationship to other clinical variables.

Methods

Subjects (N=64) were assessed by the Structured Clinical Interview for DSM-III-R and the Eysenck Personality Questionnaire. Comorbidity with other disorders, scores on Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale were assessed at baseline and after 12 months. Criteria for residual anxiety/somatic symptoms were defined.

Results

Reduction in generalized anxiety disorder rates accounted for a significant decrease in comorbidity at 1-year follow-up, with regard to baseline assessment.When the more severe symptoms of the disorder had remitted, a third of the patients referred physical symptoms with some concern over a fluctuating state of anxiety. The said symptoms were neither a recurrence of panic disorder nor did they account for other anxiety or somatoform disorders. Lower scores on extraversion predict higher risk of residual symptoms.

Discussion

The persistence of residual anxiety/somatic symptoms in a third of the patients who apparently achieved a good response to treatment of panic disorder might characterize a minor form of chronic persistence of this condition.

Conclusion

The subgroup of patients with residual symptoms would not be detectable by follow-up studies, which focus on the assessment of relapse of panic disorder by means of strictly defined diagnostic criteria.

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association Diagnostic and statistical manual of mental disorders.3rd.Washington D.C: American Psychiatric Association; 1987.Google Scholar
American Psychiatric Association Diagnostic and statistical manual of mental disorders4thWashington D.C: American Psychiatric Association; 1994.Google Scholar
Apfeldorf, W.J.Spielman, L.A.Cloitre, M.Heckelman, L.Shear, M.K.Morbidity of comorbid psychiatric diagnoses in the clinical presentation of panic disorder. Depress Anxiety 2000;12(2):7884.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Ballenger, J.C.Coryell, WWinokur, GThe Clinical Management of Anxiety Disorders New York: Oxford University Press; 1991.Google Scholar
Breier, A.Charney, D.S.Heninger, G.R.Agoraphobia with panic attacks. Development, diagnostic stability and course of illness. Arch Gen Psychiatry 1986;43:1029CrossRefGoogle ScholarPubMed
Cassano, G.B.Michelini, S.Shear, M.K.Coll, E.Maser, J.D.Frank, E.Panic-agoraphobic spectrum: from the idea to the questionnaire. Biol Psychiatry 1997;42(I S):132S132S.CrossRefGoogle Scholar
Corominas, A.Curso y factores predictores de respuesta en el trastorno por angustia con o sin agorafobia” (Course and predictive factors of response to treatment of panic disorder with or without agoraphobia). Doctoral Thesis (Director: Prof. Julio Vallejo Ruiloba). Publicacions Universitat de Barcelona, 1996. 〚Col.lecció de Tesis Doctorals Microfitxades núm. 2892.〛Google Scholar
Corominas, A.Vallejo, J.Treatment maintenance time in panic disorder with or without agoraphobia. European Neuropsychopharmacol 1996;6(suppl 4):S4140.CrossRefGoogle Scholar
Coryell, W.Noyes, R.Clancy, J.Panic disorder in primary unipolar depression: a comparison of background and outcome. J Affective Disord 1983;5:311317.CrossRefGoogle ScholarPubMed
Cross-national collaborative panic study, second phase investigators. Drug treatment for panic disorder. Comparative efficacy of alprazolam, imipramine and placebo. Br J Psychiatry 1992;160:191202.CrossRefGoogle Scholar
Eysenck, H.J.Eysenck, S.B.G.Manual of the Eysenck Personality Questionnaire(Junior & adult) London: Hodder and Stoughton; 1975 〚Spanish version: Escobar, VLobo, ASeva-Díaz, A. TEA ediciones, Madrid,1989〛.Google Scholar
Fava, G.A.Subclinical symptoms in mood disorders: pathophysiological and therapeutic implications. Psychol M 1999;29:(1):4761.CrossRefGoogle ScholarPubMed
Fava, G.A.Kellner, R.Prodromal symptoms in affective disorders. Am J Psychiatry 1991;148:823830.Google ScholarPubMed
Fava, G.A.Mangelli, L.Subclinical symptoms of panic disorder: new insights into pathophysiology and treatment. Psychother Psychosom 1999;68(6):281289.CrossRefGoogle ScholarPubMed
Fava, G.A.Rafanelli, C.Ottolini, F.Ruini, C.Cazzaro, M.Grandi, S.Psychological well-being and residual symptoms in remitted patients with panic disorder and agoraphobia. J Affect Disord 2001;65(2):185190.CrossRefGoogle ScholarPubMed
Hamilton, M.The assessment of anxiety states by rating. Br J Med Psychol 1959;32:5055.CrossRefGoogle ScholarPubMed
Hamilton, M.A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:5662.CrossRefGoogle ScholarPubMed
Hoffart, A.Thornes, K.Hedley, L.M.Strand, J.DSM-III-R axis I and axis II disorders in agoraphobic patients with and without panic disorder. Acta Psychiatr Scand 1994;89:186191.CrossRefGoogle ScholarPubMed
Hollifield, M.Katon, W.Skipper, B.Chapman, T.Ballenger, J.C.Manuzza, S.et alPanic disorder and quality of life: variables predictive of functional impairment. Am J Psychiatry 1997;154:766772.Google ScholarPubMed
Judd, L.L.Akiskal, H.S.Maser, J.D.Zeller, P.J.Endicott, J.Coryell, W.et alA prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Arch Gen Psychiatry 1998;55:694700.CrossRefGoogle ScholarPubMed
Katon, W.Vitaliano, P.P.Anderson, K.Jones, M.Russo, J.Panic disorder: residual symptoms after the acute attacks abate. Compr Psychiatrya 1987;28:151158.CrossRefGoogle ScholarPubMed
Katon, W.Vitaliano, P.P.Russo, J.Jones, M.Anderson, K.Panic disorder. Spectrum of severity and somatization. J Nerv Ment Disb 1987;175(1):1219.CrossRefGoogle ScholarPubMed
Marquez, M.Segui, J.Garcia, L.Canet, J.Ortiz, M.Is panic disorder with psychosensorial symptoms (depersonalization-derealization) a more severe clinical subtype?. J Nerv Ment Dis 2001;189(5):332335.CrossRefGoogle ScholarPubMed
Noyes, R.Comorbidity in generalized anxiety disorder. Psychiatr Clin North Am 2001;24(1):4155.CrossRefGoogle ScholarPubMed
Perugi, G.Musetti, L.Toni, C.Cassano, G.B.Long term treatment of panic disorder-agoraphobia. Proceedings of the 20th CINP Congress. Melboume, Australia, June 23–27. 1996; p.S212.Google Scholar
Reich, J.H.DSM-III personality disorders in the outcome of treatment panic disorder. Am J Psychiatry 1988;145 11491152.Google ScholarPubMed
Rosenberg, N.K.Mellergård, M.Rosenberg, R.Bech, P.Ottosson, J.O.Characteristics of panic disorder patients responding to placebo. Acta Psychiatr Scand 1991;365 (Suppl):3338.CrossRefGoogle ScholarPubMed
Savino, M.Perugi, G.Simonini, E.Soriani, A.Cassano, G.B.Akiskal, H.S.Affective comorbidity in panic disorder: is there a bipolar connection?. J Affect Disord 1993;28 155163.CrossRefGoogle Scholar
Saviotti, F.M.Grandi, S.Saxron, G.Ermentini, R.Bartolucci, G.Conti, S.et alCharacterological traits of recovered patients with panic disorder and agoraphobia. J Affect Disord 1991;23:113117.CrossRefGoogle ScholarPubMed
Shear, M.K.Frank, E.Nauri, M.Nasser, J.D.Cofi, E.Cassano, J.B.Panic-agoraphobic spectrum: preliminary data. Biol Psychiatry 1997;42(1 S):133S133S.CrossRefGoogle Scholar
Sherboume, C.D.Wells, K.B.Judd, L.L.Functioning and well-being of patients with panic disorder. Am J Psychiatry 1996;153:213218.Google Scholar
Spitzer, R.L.Endicott, J.Robins, E.Research diagnostic criteria (RDC) for a selected group of functional disorders New York: Biometries Research, New York State Psychiatric Institute; 1978;Google Scholar
Spitzer, R.L.Williams, J.B.W.Gibbon, M.First, U.B.Structured clinical interview for DSM-III-R, Version 1.0 (SCID) Washington, D.C: American Psychiatric Press; 1990.Google Scholar
Submit a response

Comments

No Comments have been published for this article.