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 panic disorder at a mean of 5.3 years following a controlled trial of treatment that included antidepressants and behavioural counselling. Method. Sixty-eight (86%) subjects were evaluated by lengthy research interview. 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 dysfunction 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 original trial did badly. Conclusions. Complete recovery can occur even after many years of severe illness in a large minority of subjects who receive both antidepressants and behavioural counselling in the acute stage of treatment. The comparative prognostic value of personality, severity and chronicity need to be more fully addressed in future studies.