The clinical course of panic disorder and depression

The evidence obtained in the past decade that depression is both chronic and recurrent in many patients has started to change the way the disorder is diagnosed and treated. The authors review findings from the Clinical Studies of the National Institute of Mental Health Collaborative Program on the Psychobiology of Depression that support the existence of high rates of chronicity and relapse in depression. They then review naturalistic studies conducted before the development of efficacious treatments for panic disorder and follow-up studies conducted in the past 10 years, both of which revealed high levels of chronicity in panic disorder patients. The implications of those findings for the diagnosis and treatment of panic disorder are discussed, and directions for future work in both depression and panic disorder are suggested.