The course of panic attacks in individuals with panic disorder and subthreshold panic disorder: a population-based study.

Although panic disorder is generally considered to be a chronic condition, little is known about the natural history of panic attacks and the factors predicting the prognosis of panic. It is expected that data derived from the community show more variation in the prognosis of panic and that subjects with less severe, 'subthreshold panic disorder' have a better prognosis. Using a large, representative population-based study, the 2-year course of panic attacks and its predictors were investigated among 155 subjects with panic disorder and subthreshold panic disorder. Presence and frequency of attacks were studied using structured interviews. Putative risk-indicators of chronicity included socio-demographics, psychobiological, environmental, psychiatric and panic-related factors. Thirty-nine percent of those with panic disorder and 17% of those with subthreshold panic disorder reported panic episodes during more than 75% of the observed time periods in the Life Chart Interview. Forty-three percent of those with panic disorder and 14% of those with subthreshold panic disorder reported over 24 attacks per 3-month period. Male gender, severity of panic and agoraphobia predicted a high proportion of time spent in panic episodes. Low self-esteem, limited positive life events and severity of panic predicted highly frequent attacks. The sample size was small, thereby limiting statistical power. The reported outcome may have overestimated chronicity. As was expected, the 2-year prognosis of panic was more varied than is often found in clinical studies. Although subthreshold panic disorder had a more favourable prognosis than full-blown panic disorder, a sizeable proportion of those with subthreshold panic disorder had an unfavourable prognosis.

Batelaan NM ，de Graaf R ，Spijker J ，Smit JH ，van Balkom AJ ，Vollebergh WA ，Beekman AT ... -  《-》

The 2-year prognosis of panic episodes in the general population.

Batelaan NM ，de Graaf R ，Penninx BW ，van Balkom AJ ，Vollebergh WA ，Beekman AT ... -  《-》

Nocturnal sleep panic and depression: relationship to subjective sleep in panic disorder.

Singareddy R ，Uhde TW 《JOURNAL OF AFFECTIVE DISORDERS》

Panic disorder and subthreshold panic in the light of comorbidity: a follow-up study.

Especially in the presence of agoraphobia and comorbid conditions, panic disorder causes significant impairment in life quality. Although there are several studies about epidemiology and clinical features, subthreshold symptoms and courses of comorbidity have not been studied sufficiently in panic disorder. The current study assessed the courses of panic disorder and subthreshold panic symptoms in consideration of the major and subthreshold comorbid conditions. Patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-diagnosed panic disorder were assessed using the panic disorder follow-up questionnaire, Panic and Agoraphobia Scale, Hamilton Depression Rating Scale, and State-Trait Anxiety Inventory. Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders was used to determine comorbidity, and all participants were received to 1-year follow-up. Comorbidity assessment showed that the threshold comorbidity decreased, while the subthreshold comorbidity increased at 1-year follow-up. Panic disorder symptom severity was decreased, but subthreshold panic symptoms continued to be present within the course of the illness. Presence of agoraphobia and duration of disease were significantly related with higher Panic and Agoraphobia Scale scores in the second assessment, and these relationships were independent from the treatment process. Even if the comorbidity and the severity of panic decrease with treatment, subthreshold panic and comorbid symptoms may still resist in panic disorder.

Oral E ，Aydin N ，Gulec M ，Oral M ... -  《-》

Economic costs of full-blown and subthreshold panic disorder.

Batelaan N ，Smit F ，de Graaf R ，van Balkom A ，Vollebergh W ，Beekman A ... -  《JOURNAL OF AFFECTIVE DISORDERS》