Relationship of past depressive episodes to symptom severity and treatment response in panic disorder with agoraphobia.

Journal Article (Clinical Trial;Journal Article;Multicenter Study)

BACKGROUND: Many investigators have reported that panic disorder (PD) patients with comorbid major depression (MD) have more severe symptoms and a poorer response to treatment than patients with PD alone. It is not known if this is due to a distinct and more serious underlying disorder in these patients or simply a result of the simultaneous presence of the two disorders. METHOD: Nondepressed patients presenting for treatment of panic disorder with agoraphobia (PDA) were studied before treatment (N = 180) and after 4 weeks of treatment with adinazolam sustained release (N = 89) or placebo (N = 91). Twenty-nine percent (N = 53) of the patients had a past history of MD. Symptom severity and treatment outcome were compared in patients with primary, secondary, single, recurrent, or no past MD. RESULTS: There were no consistent differences in symptom severity or treatment outcome in patients with a past history of primary, secondary, or single episode MD compared with patients with no history of MD. However, a small number of patients with history of recurrent MD exhibited consistently greater symptom severity and poorer response to treatment than patients with no history of MD. CONCLUSION: The greater severity and worse outcome of comorbid PD and MD observed in earlier studies are more likely due to the simultaneous presence of the two disorders than to a more serious and enduring underlying disorder. However, our results suggest that recurrent MD may indicate a more serious condition in patients with PDA. This possibility warrants further study.

Full Text

Duke Authors

Cited Authors

  • Maddock, RJ; Carter, CS; Blacker, KH; Beitman, BD; Krishnan, KR; Jefferson, JW; Lewis, CP; Liebowitz, MR

Published Date

  • March 1, 1993

Published In

Volume / Issue

  • 54 / 3

Start / End Page

  • 88 - 95

PubMed ID

  • 8468314

International Standard Serial Number (ISSN)

  • 0160-6689


  • eng

Conference Location

  • United States