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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: [email protected] (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
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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References

American Psychiatric Association Diagnostic and statistical manual on mental disorders. 4th ed.Washington, DC: APA; 2000. DSM-IV.Google Scholar
Andersch, S., Hetta, J.A 15-year follow-up study of patients with panic disorder. Eur Psychiatry 2003;18:401–408.CrossRefGoogle ScholarPubMed
Anderson, D.E.Genetics and breast cancer. In: Diaz-Faes, J., editor. Breast cancer. Advances on diagnoses and treatment. León: Santiago García; 1990. p. 42.Google Scholar
Aronson, T.A., Logue, C.M.On the longitudinal course of panic disorder: developmental history and predictors of phobic complications. Compr Psychiatry 1987;28:344–355.CrossRefGoogle Scholar
Battaglia, M., Bernardeschi, L., Politi, E.Comorbidity of panic and somatization disorder: a genetic-epidemiological approach. Compr Psychiatry 1995;36:411–420.CrossRefGoogle ScholarPubMed
Breier, A., Charney, D.S., Heninger, G.R.Agoraphobia with panic attacks. Arch Gen Psychiatry 1986;43:1029–1036.CrossRefGoogle ScholarPubMed
Bruce, S.E., Yonkers, K.A., Otto, M.W.Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Am J Psychiatry 2005;162:1179–1187.CrossRefGoogle ScholarPubMed
Bruce, S.E., Yonkers, K.A., Otto, M.W., Eisen, J.L., Weisberg, R.B., Pagano, M.et al.Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Am J Psychiatry 2005;162:1179–1187.CrossRefGoogle ScholarPubMed
Ciompi, L.Le veillissemant des hysteriques. Etude catamnestique. L'Encéphale 1966;55:287–335.Google Scholar
Corominas, A., Guerrero, T., Vallejo, J.Residual symptoms and co-morbidity in panic disorder. Eur Psychiatry 2002;17:399–406.CrossRefGoogle ScholarPubMed
Derogatis, L.R., Lipman, R.S., Covi, L.SCL-90: an outpatient psychiatric rating scale. Psychopharmacol Bull 1973;9:13–28.Google ScholarPubMed
Endicott, J., Andreasen, N.C., Spitzer, R.L.Research diagnostic criteria. (Spanish version by Humbert MS). Madrid: Editores Médicos; 1989.Google Scholar
Endicott, J., Spitzer, R.L., Fleiss, J.L., Cohen, J.The global assessment scale: a procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976;33:766–771.CrossRefGoogle ScholarPubMed
Ernst, K.Die Prognose der Neurosen. Berlin: Springer-Verlag; 1959.CrossRefGoogle Scholar
Eysenck, H.J., Eysenck, S.B.G.Manual of the Eysenck personality questionnaire. London: Hodder and Stoughton; 1975.Google Scholar
Fink, P.Psychiatric Illness in patients with persistent somatization. Br J Psychiat 1995;166:93–99.CrossRefGoogle Scholar
Garcia-Campayo, J., Sanz-Carrillo, C., Claraco, L.M.The challenge of somatizations: the need for liaison units primary care-mental health. Primary Care Psychiatry 1997;3:163–169.Google Scholar
Goisman, R., Warshaw, M., Peterson, L., Rogers, M.P., Cuneo, P., Hunt, M.F.et al.Panic, agoraphobia, and panic disorder with agoraphobia. Data from a multicenter anxiety disorders study. J Nerv Ment Disease 1994;182:72–79.CrossRefGoogle ScholarPubMed
Goldstein, R.B., Wickramaratne, P., Horwath, E., Weissman, M.M.Familial aggregation and phenomenology of “early”-onset at or before age 20 years panic disorder. Arch Gen Psychiatry 1997;54:271–278.CrossRefGoogle ScholarPubMed
Gorman, J.M.Panic disorders. Modern Problems Pharmacopsychiatry 1987;22:36–90.CrossRefGoogle ScholarPubMed
Jarwik, L.F., Russell, D.Anxiety, aging and the third emergency reaction. J Gerontol 1979;34:197–200.Google Scholar
Kastentaum, R.J.Habituation as a model of human aging. Int J Aging Hum Dev 1980;12:159–170.CrossRefGoogle Scholar
Kastenbaum, R.J.When aging begins: a lifespan developmental approach. Res Aging 1984;6:105–117.CrossRefGoogle ScholarPubMed
Katon, W., Vitaliano, P.P., Anderson, K., Jones, M., Russo, J.Panic disorder: residual symptoms after the acute attacks abate. Compr Psychiatry 1987;28:151–158.CrossRefGoogle ScholarPubMed
Katsching, H., Amering, M., Stolk, J., Klerman, G., Ballenger, J., Briggs, A.et al.Long-term follow-up after a drug trial for panic disorder. Br J Psychiatry 1995;167:487–494.CrossRefGoogle Scholar
Kellner, R.Psychosomatic syndromes, somatization and somatoform disorders. Psychother Psychosom 1994;61:4–24.CrossRefGoogle ScholarPubMed
Leff, J.Psychiatry around the globe. 1994 Gaskell/Royal College of Psychiatrists; London.Google Scholar
Lepola, U., Koponen, H., Leinonen, E.A naturalistic 6-year follow-up study of patients with panic disorder. Acta Psychiatr Scand 1996;93:181–183.CrossRefGoogle ScholarPubMed
Levin, B., Raijman, I.Malignant tumors of the colon and rectum. In: Hanbrich, W.S., Schaffner, F., Berk, J.E.Bockus gastroenterology Philadelphia: WB Saunders CO; 1994. p. 1744.Google Scholar
Liebowitz, M.R.Panic disorder as a chronic illness. J Clin Psychiatry 58Suppl. 131997 5–8.Google ScholarPubMed
Lipowsky, Z.J.Somatization: the concept and its clinical application. Am J Psychiatry 1988;145:1358–1368.Google Scholar
López Ibor JJ, Basic anxiety as the core of neurosis. Acta Psychiatr Scand 1965;41:329–332.Google ScholarPubMed
López Ibor, J.J.La angustia vital. Madrid: Paz Montalvo; 1966.Google Scholar
López Ibor, J.J.Las neurosis como enfermedades del ánimo. Madrid: Gredos; 1966.Google Scholar
López-Ibor, J.J. Jr.Nosological status of endogenous anxiety: ‘anxious thymopathy’ revisited. Psychopathology 1985;18:133–139.Google ScholarPubMed
McCarthy, P.R., Katz, I.R., Foa, E.B.Cognitive-behavioral treatment of anxiety in the elderly: a proposed model. In: Salzman, C., Lebowitz, B.D.Anxiety in the elderly: treatment and research New York: Springer; 1991. p. 197–214.Google Scholar
Noyes, R. Jr., Clancy, J., Woodman, C.Environmental factors related to the outcome of panic disorder: a seven-year follow-up study. J Nerv Ment Dis 1993;181:529–538.CrossRefGoogle ScholarPubMed
Noyes, R. Jr., Garvey, M., Cook, B., Samuelson, L.Problems with tricyclic antidepressant use in patients with panic disorder or agoraphobia. Results of a naturalistic follow-up study. J Clin Psychiatry 1989;50:163–169.Google ScholarPubMed
Noyes, R. Jr., Reich, J.Outcome of panic disorder relationship to diagnostic subtypes and co-morbidity. Arch Gen Psychiatry 1990;47:809–818.CrossRefGoogle Scholar
O'Rourke, D., Fahy, T.J., Brophy, J., Prescott, P.The Galway study of panic disorder III: outcome at 5 to 6 years. Br J Psychiatry 1996;168:462–469.CrossRefGoogle ScholarPubMed
Perna, G., Bertani, A., Caldirola, D., Bellodi, L.Family history of panic disorder and hypersensitivity to CO2 in patients with panic disorder. Am J Psychiatry 1996;153:1060–1064.Google ScholarPubMed
Person, D.C., Borkovez, T.D.Anxiety disorders among the elderly: pattern and issues. Paper presented at the annual meeting of the American Psychological Association, New York, NY; 1995, August.Google Scholar
Pollack, M.H., Smoller, J.W.The longitudinal course and outcome of panic disorder. Psychiatr Clin North Am 1995;18:785–801.CrossRefGoogle ScholarPubMed
Roy-Byrne, P.P., Cowley, D.S.Course and outcome in panic disorder: a review of recent follow-up studies. Anxiety 1994;1:151–160.CrossRefGoogle ScholarPubMed
Rubio, G., Course of anxiety disorders: a catamnestic study (Thesis). Alcalá de Henares, Spain: University of Alcalá; 1988.Google Scholar
Schneider, K.Klinische Psychopathologie (Neunte, unveränderte Auflage). 1971; Stuttgart Georg Thieme Verlag; 1971.Google Scholar
Sheehan, D.V.Currents concepts in psychiatry: panic attacks and phobias. N Engl J Med 1982;307:156–158.CrossRefGoogle Scholar
Spitzer, R.L., Williams, J.B.W., Gibbon, M., First, U.B.Structured interview for DSM-III-R (SCID). Biometrics Research Department. New York, NY: New York State Psychiatric Institute; 1987.Google Scholar
Swoboda, H., Amering, M., Windhaber, J., Katsching, H.The long-term course of panic disorder -an 11-year follow-up. Anxiety Dis 2003;17:223–232.CrossRefGoogle ScholarPubMed
Torgersen, S.Genetics factors in anxiety disorders. Arch Gen Psychiatry 1983;40:1085–1089.CrossRefGoogle ScholarPubMed
Turner, W.M., Cutter, H.S., Worobec, T.G., O'Farrell, T.J., Bayog, R.D., Tsuang, M.T.Family history models of alcoholism: age of onset, consequences and dependence. J Stud Alcohol 1993;54:164–171.CrossRefGoogle ScholarPubMed
Tyrer, P., Seivewright, H., Johnson, T.The Nottingham study of neurotic disorder: predictors of 12-year outcome of dysthymic, panic and generalized anxiety disorder. Psychol Med 2004;34:1358–1394.CrossRefGoogle ScholarPubMed
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