[Prognostic aspects of panic disorder]

Panic disorder is considered as a qualitatively distinct form among the anxiety disorders. Follow-up studies have demonstrated that the course of panic disorder may be chronic. Only one out of ten patients remains completely free of symptoms within an observational period of 3 to 7 years. The majority of patients suffer long-standing anxiety symptoms which do not significantly interfere with working performance or social relationships. Another ten percent of the patients are continuously impaired in everyday living by severe symptoms. Long duration and severe degree of symptoms at the initial assessment, as well as coexistent depression are associated with a poor outcome. There is evidence of an increased mortality in patients with panic disorder. Suicides are overrepresented among the causes of death. It is not clear whether this is due to the frequent comorbidity between panic disorder, major depression, and substance abuse.