Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder.
|Title||Predictors of clinical improvement in a randomized effectiveness trial for primary care patients with panic disorder.|
|Publication Type||Journal Article|
|Year of Publication||2009|
|Authors||Chavira, DA, Stein MB, Golinelli D, Sherbourne CD, Craske MG, Sullivan G, Bystritsky A, Roy-Byrne PP|
|Journal||The Journal of nervous and mental disease|
|Date Published||2009 Oct|
|Keywords||Adolescent, 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|
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.
|Alternate Journal||J. Nerv. Ment. Dis.|