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Trauma and defense style as response predictors of pharmacological treatment in panic patients

Published online by Cambridge University Press:  16 April 2020

Letícia Kipper ,
Carolina Blaya ,
Cláudia Wachleski ,
Marina Dornelles ,
Giovanni Abrahão Salum ,
Elizeth Heldt  and
Gisele G. Manfro
Letícia Kipper
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry. School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de ClÍnicas de Porto Alegre. Ramiro Barcelos 2350, room 400N, CEP: 90035-003, Porto Alegre, RS, Brazil
Carolina Blaya
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry. School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de ClÍnicas de Porto Alegre. Ramiro Barcelos 2350, room 400N, CEP: 90035-003, Porto Alegre, RS, Brazil
Cláudia Wachleski
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry. School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de ClÍnicas de Porto Alegre. Ramiro Barcelos 2350, room 400N, CEP: 90035-003, Porto Alegre, RS, Brazil
Marina Dornelles
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry. School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de ClÍnicas de Porto Alegre. Ramiro Barcelos 2350, room 400N, CEP: 90035-003, Porto Alegre, RS, Brazil
Giovanni Abrahão Salum
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry. School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de ClÍnicas de Porto Alegre. Ramiro Barcelos 2350, room 400N, CEP: 90035-003, Porto Alegre, RS, Brazil
Elizeth Heldt
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry. School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de ClÍnicas de Porto Alegre. Ramiro Barcelos 2350, room 400N, CEP: 90035-003, Porto Alegre, RS, Brazil
Gisele G. Manfro*
Affiliation:
Post Graduate Program in Medical Sciences: Psychiatry. School of Medicine, Universidade Federal do Rio Grande do Sul and Anxiety Disorders Program, Hospital de ClÍnicas de Porto Alegre. Ramiro Barcelos 2350, room 400N, CEP: 90035-003, Porto Alegre, RS, Brazil
*
*Corresponding author. Present address: Luis Manoel Gonzaga 630/11 CEP: 90470-280 Porto Alegre, RS, Brazil. Tel.: +55 51 33309272; fax: +55 51 33289234. E-mail addresses: [email protected] (L. Kipper), [email protected] (C. Blaya), [email protected] (C. Wachleski), [email protected] (M. Dornelles), [email protected] (G.A. Salum), [email protected] (E. Heldt), [email protected] (G.G. Manfro).
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Abstract

Background

As panic disorder (PD) has a chronic course, it is important to identify predictors that might be related to non-remission. The aim of this study is to verify whether history of trauma and defense style are predictors to pharmacological treatment response in PD patients.

Method

The sample was composed by 47 PD patients according to DSM-IV who were treated with sertraline for 16 weeks. Evaluations were assessed by the C.G.I. (Clinical Global Impression), the Hamilton-Anxiety Scale, the Hamilton-Depression Scale, the Panic Inventory and the DSQ-40 (Defense Style Questionnaire) at baseline and after treatment.

Results

Full remission was observed in 61.7% of the sample. The predictors significantly associated with non-remission were: severity of PD (p = 0.012), age of onset (p = 0.02) and immature defenses (p = 0.032). In addition, the history of trauma was associated with early onset of PD (p = 0.043).

Conclusion

Panic patients had as predictors of worse response to pharmacological treatment the early onset and the severity of PD symptoms as well as the use of immature defenses at baseline. This finding corroborates the relevance of the evaluation of factors that might affect the response so as to enable the development of appropriate treatment for each patient.

Keywords

Panic disorderPredictorsOutcomeTreatment responseTraumaDefense style
Type
Original article
Information
European Psychiatry , Volume 22 , Issue 2 , March 2007 , pp. 87 - 91
Copyright
Copyright © Elsevier Masson SAS 2006

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