Panic-agoraphobic spectrum: reliability and validity of assessment instruments

DSM IV is a simple, reliable diagnostic system with many advantages. Howeve r, DSM diagnostic criteria may not provide sufficient characterization of c linically significant symptoms. We have undertaken a project to assess an a rray (spectrum) of clinical features associated with different DSM Disorder s. The purpose of this paper is to report on reliability of assessment inst ruments for Panic-Agoraphobic Spectrum (PAS). to document convergent validi ty of PAS symptom groupings. and to confirm the relationship between PAS an d DSM IV Panic Disorder (PD). We studied 22 normal controls and 95 outpatie nts who met criteria for Panic Disorder with and without lifetime Major Dep ression, and Major Depression or Obsessive Compulsive Disorder without life time Panic Disorder. Assessment instruments had excellent reliability and t here was good concordance between interview and self-report formats. PAS sc ores were highest in subjects with PD, followed by outpatients without PD, and were lowest in normal controls. PAS scores varied among PD patients, an d a subgroup of patients without PD scored high on PAS. We conclude that PA S can be reliably assessed, and that it describes a valid, coherent constel lation of features associated with DSM IV Panic Disorder, but providing add itional important clinical information. (C) 2001 Elsevier Science Ltd. All rights reserved.