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Panic, agoraphobia, and panic disorder with agoraphobia. Data from a multicenter anxiety disorders study
R M Goisman1, M G Warshaw, L G Peterson
1Massachusetts Mental Health Center, Boston 02115.
The Journal of Nervous and Mental Disease
|February 1, 1994
Summary
Agoraphobia without history of panic disorder (AWOPD) is linked to worse functioning, while panic disorder (PD) shows better outcomes. Panic disorder with agoraphobia (PDA) falls in between, with similar treatments across diagnoses.
Area of Science:
- Psychiatry
- Clinical Psychology
- Anxiety Disorders Research
Background:
- DSM-III-R diagnostic criteria differentiate panic disorder (PD), panic disorder with agoraphobia (PDA), and agoraphobia without history of panic disorder (AWOPD).
- Understanding the distinct clinical profiles and functioning levels of these related anxiety disorders is crucial for targeted interventions.
Purpose of the Study:
- To compare demographic, descriptive, comorbidity, treatment, and course data across PD, PDA, and AWOPD.
- To elucidate the relative severity and functional impact of these DSM-III-R defined conditions.
Main Methods:
- Cross-sectional analysis of data from 562 subjects in a multicenter anxiety-disorders study.
- Evaluation of functioning based on episode length, education, financial aid, depressive comorbidity, and symptom-free periods.
Main Results:
- AWOPD subjects exhibited the poorest functioning, while PD subjects demonstrated the best.
- PDA was the most prevalent diagnosis, presenting intermediate severity.
- Treatment patterns showed minimal variation, with benzodiazepines and psychodynamic psychotherapy being common; exposure therapy was more frequent in AWOPD.
Conclusions:
- Significant differences in functional impairment exist among PD, PDA, and AWOPD.
- Treatment approaches were largely consistent across these diagnoses, suggesting potential areas for therapeutic refinement.
- Exposure therapy may be particularly relevant for individuals with AWOPD.