Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-25T18:18:49.971Z Has data issue: false hasContentIssue false

Treatment of panic disorder with alprazolam and imipramine: clinical relevance of DSM III dysthymia

Published online by Cambridge University Press:  16 April 2020

R Rosenberg
Affiliation:
Institute for Basic Research in Psychiatry, Psychiatric Hospital, University Hospital of Aarhus, Skovagervej 2, DK-8240 , Risskov, Denmark
P Nøhr Jensen
Affiliation:
Institute for Basic Research in Psychiatry, Psychiatric Hospital, University Hospital of Aarhus, Skovagervej 2, DK-8240 , Risskov, Denmark
Get access

Summary

The presence of affective symptoms in panic disorder has often been reported. Data from The Cross-National Collaborative Panic Study (second phase) were analysed to address the role of dysthymia in panic disorder with respect to previous illness, current psychopathology and the outcome during an 8-week study of alprazolam and imipramine. A group of dysthymic patients without current or past major depressive episode was studied. The prevalences of dysthymia varied markedly across participating sites: 2–13%. Only a few clinical characteristics of dysthymic panic disorder patients were found. They had suffered from panic disorder for a few years more than patients without affective disorder and they were slightly older. The outcome after the 8-week drug trial was not significantly different from that of patients without affective disorder. Hence, dysthymia was not suggested to be of major clinical relevance for the phenomenology of panic disorder or for the outcome of drug treatment.

Type
Original article
Copyright
Copyright © Elsevier, Paris 1994

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 Edn, American Psychiatric Association, Washington: APA,1980Google Scholar
Aronson, TA. Is panic disorder a distinct diagnostic entity? A critical review of the borders of a syndrome. J Nerv Ment Dis 1987;175:584–94CrossRefGoogle ScholarPubMed
Ballenger, JCBurrows, GDDuPont, RLLesser, IMNoyes, RPecknold, JCRifkin, ASwinson, RP. Alprazolam in panic disorder and agoraphobia: results from a multicenter trial. I. Efficacy in short-term treatment. Arch Gen Psychiatry 1988;45:413–22CrossRefGoogle ScholarPubMed
Breier, ACharney, DSHeninger, GR. Major depression in patients with agoraphobia and panic disorder. Arch Gen Psychiatry 1984;41:1129–35CrossRefGoogle ScholarPubMed
Breier, ACharney, DSHeninger, GR. The diagnostic validity of anxiety disorders and their relationship to depressive illness. Am J Psychiatry 1985;142:787–97Google ScholarPubMed
Deltito, JAArgyle, NKlerman, GL. Patients with panic disorder unaccompanied by depression improve with alprazolam or imipramine treatment. J Clin Psychiatry 1991;52:121–7Google ScholarPubMed
Hamilton, M. The assessment of anxiety by rating. Br J Med Psychol 1959;32:50–5CrossRefGoogle ScholarPubMed
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:50–6CrossRefGoogle Scholar
Kocsis, JHFrances, AJ. A critical discussion of DSM III dysthymic disorder. Am J Psychiatry 1987;144:1534–42Google ScholarPubMed
Klerman, GL. Overview of the Cross-National Collaborative Panic Study. Arch Gen Psychiatry 1988;45:407–12CrossRefGoogle ScholarPubMed
Maier, WRosenberg, RArgyle, NRoth, MBrandon, SBenkert, O. Avoidance behavior and major depression in panic disorder: a report from the Cross-National Collaborative Panic Study. Psychiatr Dev 1989;7:123–42Google Scholar
Maier, WRosenberg, RArgyle, NRoth, MBrandon, SBenkert, O. Subtyping panic disorder by major depression and avoidance behaviour and the response to active treatment. Eur Arch Psychiatry Clin Neurosci 1991;241:2230CrossRefGoogle ScholarPubMed
Marks, IMMatthews, AM. Brief standard self-rating for phobic patients. Behav Res Ther 1979;17:263–7CrossRefGoogle ScholarPubMed
Noyes, RReich, JChristiansen, JSuelzer, MPfohl, BCoryell, WA. Outcome of panic disorder. Relationship to diagnostic subtypes and comorbidity. Arch Gen Psychiatry 1990;47:809–18CrossRefGoogle ScholarPubMed
Reich, JH. DSM III personality disorders and the outcoume of treated panic disorder. Am J Psychiatry 1988;145:1149–52Google ScholarPubMed
Rosenberg, RBech, PMellergard, MOttosson, JO. Panic disorder (DSM III and DSM III-R) as a nosological entity -a review of main validation criteria. Acta Psychiatry Stand 1991a; 83 (suppl 365) 717CrossRefGoogle Scholar
Rosenberg, RBech, PMellergård, MOttosson, JO. Secondary depression in panic disorder: an indicator of severity with a weak effect on outcome in alprazolam and imipramine treatment. Acta Psychiatr Scand 1991b;83 (suppl 365):3945CrossRefGoogle Scholar
Roth, MArgyle, N. Anxiety, panic and phobic disorders: an overview. J Psychiatr Res 1988;22 (suppl 1):3354CrossRefGoogle ScholarPubMed
SAS/STAT Guide for Personal Computers. Version 6, edn Cary:SAS Institute Inc. 1987Google Scholar
Second Phase Investigators. Cross-National Collaborative Panic Study. Drug treatment of panic disorder. Comparative efficacy of alprazolam, imipramine, and placebo. Br J Psychiatry 1992;160:191202CrossRefGoogle Scholar
Spitzer, RLWilliams, JB. Revised diagnostic criteria and a new structured interview for diagnosing anxiety disorder. J Psychiatry Res 1988;22:5586CrossRefGoogle Scholar
Tyrer, PSeivewright, NFerguson, BTyrer, J. The general neurotic syndrome: a coaxial diagnosis of anxiety, depression. Acta Psychiatr Scand 1992;85:201–6CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.