Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder.

TitlePredictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder.
Publication TypeJournal Article
Year of Publication2009
AuthorsChavira, DA, Stein MB, Golinelli D, Sherbourne CD, Craske MG, Sullivan G, Bystritsky A, Roy-Byrne PP
JournalThe Journal of nervous and mental disease
Volume197
Issue10
Pagination715-21
Date Published2009 Oct
ISSN1539-736X
KeywordsAdolescent, Adult, Aged, Anti-Anxiety Agents, Cognitive Therapy, Combined Modality Therapy, Comorbidity, Female, Follow-Up Studies, Humans, Logistic Models, Male, Middle Aged, Panic Disorder, Personality Assessment, Phobic Disorders, Primary Health Care, Probability, Psychiatric Status Rating Scales, Severity of Illness Index, Treatment Outcome
Abstract

This study's aim was to prospectively examine and identify a model of demographic, clinical, and attitudinal variables that impact improvement among patients with panic disorder. Subjects were 232 primary care patients meeting criteria for DSM-IV panic disorder. Eligible patients were randomly assigned to a collaborative care intervention or to treatment as usual. Assessments occurred at 3-month intervals during the course of 1 year. In final multivariate logistic regression models, patients with higher anxiety sensitivity and higher neuroticism scores at baseline were less likely to show clinical improvement (using a criterion of 20 or less on the Anxiety Sensitivity Index) at 3 months. Those who were non-white, had higher anxiety sensitivity, and higher overall phobic avoidance at baseline were less likely to show clinical improvement at 12 months. A greater understanding of these predictors may help clinicians identify who is at greatest risk for persistent panic-related symptoms and to plan the intensity of interventions accordingly.

DOI10.3928/01913913-20090706-05
Alternate JournalJ. Nerv. Ment. Dis.