THE GALWAY STUDY OF PANIC DISORDER .3. OUTCOME AT 5 TO 6 YEARS

Background. The aim was to evaluate long-term outcome of DSM-III-R pan ic disorder at a mean of 5.3 years following a controlled trial of tre atment that included antidepressants and behavioural counselling. Meth od. Sixty-eight (86%) subjects were evaluated by lengthy research inte rview. Results. Thirty-four per cent recovered and remained well, 46% were minimally impaired and 20% had persistent panic disorder of whom half remained significantly impaired. Anxious fearful personality dysf unction was the most important predictor of poor outcome, followed by poor clinical status at discharge and inability at baseline to recall vividly the initial panic attack. Those who dropped out from the origi nal trial did badly. Conclusions. Complete recovery can occur even aft er many years of severe illness in a large minority of subjects who re ceive both antidepressants and behavioural counselling in the acute st age of treatment. The comparative prognostic value of personality, sev erity and chronicity need to be more fully addressed in future studies .