Panic disorder and agoraphobia: A direct comparison of their multivariate comorbidity patterns (original) (raw)
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Patterns of comorbidity in panic disorder and agoraphobia
Psychiatry Research, 1992
Diagnoses of comorbid disorders were determined in a sample of 54 patients with panic disorder as defined in DSM-III-R. The sample was divided into the following three groups: (1) uncomplicated panic disorder (PDU);
An examination of levels of agoraphobic severity in panic disorder
Behaviour Research and Therapy, 1995
Based on the results of previous studies, several factors believed to be related to the development of agoraphobia were simultaneously assessed in 195 panic disorder patients (57 males, 138 females) with various levels of DSM-III-R-defined agoraphobia: none, mild, moderate, or severe. The four groups of patients significantly differed from each other on self-reports of phobic avoidance, although all the groups reported a similar type of panic attack. The four groups also did not significantly differ on catastrophic panic cognitions (e.g. fear of dying), fear of anxiety symptoms (anxiety sensitivity), or variables related to spontaneous panic. Neither severity or frequency of panic was predictive of severity of agoraphobia. The anticipation of panic only in relation to agoraphobic situations was predictive of severity of agoraphobia, followed by perceived lifestyle restrictions due to panic, and trait anxiety regarding ambiguous or novel situations. Regardless of level of agoraphobia, patients tended to avoid situations where they anticipated panic would occur, indicating that panic and agoraphobia do not share a unique or exclusive relationship. Panic disorder with various levels of phobic avoidance, rather than just agoraphobia, would appear to be a more valid diagnostic category.
Panic disorder and agoraphobia: an overview and commentary on DSM-5 changes
Depression and anxiety, 2014
The recently published DSM-5 contains a number of changes pertinent to panic disorder and agoraphobia. These changes include separation of panic disorder and agoraphobia into separate diagnoses, the addition of criteria and guidelines for distinguishing agoraphobia from specific phobia, the addition of a 6-month duration requirement for agoraphobia, the addition of panic attacks as a specifier to any DSM-5 diagnosis, changes to descriptors of panic attack types, as well as various changes to the descriptive text. It is crucial that clinicians and researchers working with individuals presenting with panic attacks and panic-like symptoms understand these changes. The purpose of the current paper is to provide a summary of the main changes, to critique the changes in the context of available empirical evidence, and to highlight clinical implications and potential impact on mental health service utilization. Several of the changes have the potential to improve access to evidence-based t...
A Prospective Study of Panic and Anxiety in Agoraphobia with Panic Disorder
British Journal of Psychiatry, 1992
The features of panic and anxiety in the natural environment were studied by prospective self-monitoring in 39 patients with chronic agoraphobia and panic disorder. Panics overlapped greatly with anxiety episodes but were more intense. Panics occurred more often in public places than did anxiety episodes, but had otherwise similar symptom profile, time of occurrence, and antecedents. Most panics surged out of a pre-existing plateau of tonic anxiety which lasted most of the day. Spontaneous panics were less frequent than situational panics and occurred more often at home but were otherwise similar. These findings do not support the sharp distinction between panic and anxiety in DSM–III–R, not its emphasis on spontaneous panic in classifying anxiety disorders. Thoughts of dying and ‘going crazy’/losing control accompanied only a minority of panic/anxiety episodes and seemed to be a product of intense panic rather than a cause.
A discussion of various aspects of panic disorder depending on presence or absence of agoraphobia
Comprehensive Psychiatry, 2016
Objective: The quality of life of individuals with panic disorder and agoraphobia can be improved by the alleviation of agoraphobia. In other words, examining panic disorder in terms of whether agoraphobia is present is crucial. The current study examined panic disorder from this perspective. Methods: Subjects were 253 patients who met the diagnostic criteria for panic disorder (lifetime) according to the Mini International Neuropsychiatric Interview (MINI). Of those patients, 179 had agoraphobia and 74 did not. Statistical analysis was used to examine gender differences in the presence (or absence) of agoraphobia, comorbidities, and the effects of the presence of agoraphobia (severity, assessment of depression, assessment of anxiety, and personality) in these patients. Results: Results indicated gender differences in the presence (or absence) of agoraphobia. Compared to patients without agoraphobia, significantly more patients with agoraphobia were female (p b .001), and had a higher prevalence of comorbidities. Patients with agoraphobia had a higher suicide risk (p b .05), more hypomanic episodes (current) (p b .05), and more frequent episodes of social phobia (p b .05). In addition, patients with agoraphobia had more severe panic disorder and a higher level of neuroticism, sensitivity to anxiety, and trait anxiety [PDSS-J, P&A, NEON: p b .01, ASI, STAI (Trait Anxiety): p b .05]. Conclusions: The current findings suggest that when treating a panic disorder, diagnosing the presence of agoraphobia is extremely important.
A comparison of panic disorder and agoraphobia with panic attacks
Comprehensive Psychiatry, 1985
The validity of distinguishing between the diagnoses of panic disorder and agoraphobia with panic attacks was examined in a study of 20 patients with each disorder. Comparison of demographic, psychometric, and clinical features of the two groups revealed few differences. Agoraphobics scored higher on ratings of interpersonal sensitivity, phobic anxiety, paranoid ideation, and alcohol use. Panic disorder patients more frequently reported periods of remissions from anxiety symptomatology. These results support the validity of conceptualizing agoraphobia with panic attacks and panic disorder as subcategories of a core endogenous anxiety disorder.
Clinical Features in Panic Disorder with Agoraphobia
Journal of Anxiety Disorders, 1998
This study compared 96 women and 58 men suffering from panic disorder with agoraphobia. Participants completed questionnaires assessing various clinical features associated with panic disorder with agoraphobia (PDA), general adjustment, and drug/alcohol use. Results showed that PDA is a more severe condition in women. Women reported more severe agoraphobic avoidance when facing situations or places alone, more catastrophic thoughts, more body sensations, and higher scores on the Fear Survey Schedule. Also, women more often had a comorbid social phobia or posttraumatic stress disorder. The lower agoraphobic avoidance of men was associated with their alcohol use. However, there were no differences between genders in other dimensions, including depression, situational and trait anxiety, stressful life events, social selfesteem, marital adjustment, and drug use.
The development of agoraphobia in panic disorder: a predictable process?
Journal of Affective Disorders, 2000
Background: Panic attacks are conceptualized to be the central feature of both panic disorder without (PDU) and with agoraphobia (PDA). As a sizeable percentage of panic patients do not develop avoidance behavior, other factors than 'panic attacks', in general, must influence the different courses of the disorder. Method: We studied 84 outpatients suffering from PDU or PDA concerning different factors which were hypothesized to influence the development of agoraphobia. Results: 'Earlier age of onset', 'fear of losing control' and 'chills or hot flushes' turned out to correlate statistically significantly with PDA, while 'chest pain or discomfort' occurred more often in PDU. Limitations: The present study used retrospective data. Conclusions: The results of this study suggest that the development of agoraphobia in panic disorder is influenced by specific variables and is not a purely coincidental process.
Panic Disorder and Agoraphobia Across the Lifespan
International Encyclopedia of the Social & Behavioral Sciences, 2015
This article is aimed to give a short overview over the most important features and research findings about panic disorder and agoraphobia. The diagnostic criteria will be discussed reviewing the changes in the history of the Diagnostic Statistical Manual for Mental Disorders. Epidemiology will be reviewed within development and maintenance factors. Different theoretical models will be discussed and the evidence-based treatment approach will be explained. Possible mechanisms of change are explained and the article ends with a short overview of clinical implications and future directions of research.
Psychiatry Research, 1995
Panic disorder patients with agoraphobia (n = 32) and agoraphobic patients without panic disorder (n = 18) who were participants in an inpatient behavioral-psychodynamic treatment program were assessed repeatedly from pretreatment to 2-year posttreatment follow-up. At pretreatment, there were statistical trends for more of the panic with agoraphobia patients to have obsessive-compulsive disorder and alcohol abuse/dependence, and for more of the agoraphobia without panic patients to have generalized anxiety disorder and avoidant personality disorder. There was also a trend for more of the panic with agoraphobia patients to have met criteria for major depression during the 2-year follow-up period.