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What can be learnt from the natural history of anxiety disorders?

Published online by Cambridge University Press:  16 April 2020

Gabriel Rubio  and
Juan José López-Ibor Jr.
Gabriel Rubio*
Affiliation:
Retiro Mental Health Centre, Psychiatry, Lope de Rueda, 43, 28009Madrid, Spain Complutense University of Madrid, Psychiatry Department, Madrid, Spain
Juan José López-Ibor Jr.
Affiliation:
Complutense University of Madrid, Psychiatry Department, Madrid, Spain Institute of Psychiatry and Mental Health, Hospital Clinico San Carlos, Madrid, Spain
*
*Corresponding author. Centro de Salud Mental de Retiro, Lope de Rueda, 43, 28009, Madrid, Spain. Tel./fax: +34 91 400 8690. E-mail address: garuva@inicia.es (G. Rubio).
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Abstract

Background

There is insufficient knowledge of the long-term course of panic disorder (PD).

Aim

To determine the long-term course and prognostic variables in patients diagnosed with PD.

Methods

Patients who were diagnosed of anxiety states between 1950 and 1961, were examined using a structured clinical interview (SCID-DSM-III-R) between 1984 and 1988 (n = 144). A re-examination was performed in the period 1997–2001 (N = 125). Mean length of follow-up from onset was 47 years.

Results

PD tends to be chronic. Among those who recovered, 93% had done so already by the 1980s. Lack of regular treatment compliance, progression to agoraphobia and number of episodes of panic disorder were associated with worse outcome. Agoraphobia without panic attacks and somatization symptoms were the most prevalent clinical status at follow-up.

Conclusion

After several decades, participants improve with regard to number of panic attacks, though most continue to have residual symptoms.

Keywords

Anxiety disorderPanic disorderAgoraphobiaSomatizationFollow-up

Information

Type
Original article
Information
European Psychiatry , Volume 22 , Issue 2 , March 2007 , pp. 80 - 86
Copyright
Copyright © Elsevier Masson SAS 2006

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