PATIENT STAGE OF CHANGE PREDICTS OUTCOME IN A PANIC DISORDER MEDICATION TRIAL

Objective: The authors test the hypothesis that patient readiness to c hange predicts outcome in a placebo-controlled medication trial. Metho d: Outpatients with panic disorder and agoraphobia completed the Stage s of Change (SOC) questionnaire, a measure of readiness to change, bef ore being randomly assigned either sustained release (SR) adinazolam o r placebo in a 4 week double-blind trial. Results: In the ''intent to treat'' analysis, for the 202 subjects who made at least one visit aft er baseline, adinazolam SR was significantly more effective than place bo on most major outcome measures. Of the 126 subjects who completed t he SOC questionnaire, regression analyses showed significant correlati ons between SOC scores and all 5 outcome measures. In a second analysi s, cluster membership based on SOC scores was predictive of outcome on 3 of 5 measures. In each statistical analysis, subjects who were not predisposed to change as measured by the SOC were significantly less l ikely to change. Conclusions: Patient readiness to change was strongly correlated with outcome in a placebo-controlled panic disorder trial with an effective medication. In this study, the SOC category, Precont emplation (i.e., those subjects who reported the belief that they had no problem) were less likely to change compared to those who believed that they had a problem. (C) 1994 Wiley-Liss, Inc.