LONG-TERM EFFECTS OF BEHAVIORAL TREATMENT FOR PANIC DISORDER WITH AGORAPHOBIA

Background. There are few long-term follow-up studies of panic disorde r treatments, particularly when patients have been treated by behaviou ral methods only and have recovered. Method. 110 consecutive patients satisfying the DSM-III-R criteria for panic disorder with agoraphobia were treated in an out-patient clinic with behavioural methods based o n exposure. After 12 sessions of psychotherapy, 81 patients became pan ic-free. A 2-9 year follow-up was available. Survival analysis was emp loyed to characterise the clinical course of patients. Regular assessm ents by a clinical psychologist were based on the Clinical interview f or Depression. Results. The estimated cumulative percentage of patient s remaining in remission was 96.1% for at least two years, 77.6% for a t least five years, and 67.4% for at least seven years. These outcomes greatly improved in the absence of a personality disorder or residual agoraphobia after treatment. Conclusions, The findings suggest that, even though one patient in four is unable to complete treatment or doe s not benefit sufficiently from it, exposure treatment can provide las ting relief for the majority of patients. Disappearance of residual an d subclinical agoraphobic avoidance, and not simply of panic attacks, should be the aim of exposure therapy.