Course and outcome in panic disorder: a review of recent follow-up studies

This paper reviews the methodologic considerations that are important in evaluating and interpreting panic disorder outcome studies and the results of the most well-designed of these studies. Sixteen studies that used modern diagnostic criteria and interviewed at least 25 patients on at least two occasions over a minimum follow-up period of one year are reviewed. Results show that, despite the availability of effective anti-panic treatments, panic disorder remains a chronic illness. While most patients improve, few are "cured." The presence of agoraphobia, major depression and personality disorder seems to predict poorer outcome. The importance of measuring multiple clinical dimensions of panic is emphasized, along with the need to reach a consensus about the definition of "outcome" and the particular instruments to use to measure it.