Impact of stressful life events on the course of panic disorder in adults

BackgroundThere is a limitation of data about factors associated with treatment response in panic disorder (PD) patients at long-term follow-up period. The aim of this study was to evaluate the long-term treatment response of pharmacotherapy-resistant patients with PD after 5 years of cognitive-behavior group therapy (CBGT) and to identify factors that predict this outcome.MethodSixty-four patients who completed 12 sessions of CBGT were followed for 5-year. Outcome measures were evaluated by the Clinical Global Impression (CGI) and quality of life (QoL) using WHOQOL-bref. Demographic and clinical features, stressful life events were the variables investigated as predictors of CBGT response across follow-up period.ResultsTreatment was associated with significant reduction in symptoms severity (agoraphobia, anticipatory anxiety and panic attacks) with maintenance of gains at 5-year of follow-up (p < 0.05). Twenty-four (40%) of the sample remained in remission after 5 years, 12 (20%) relapsed during the follow-up period and 24 (40%) were non-responder to CBGT. The poor CBGT response had an important negative impact in QoL. Regression analyzes showed that comorbidity with dysthymia (p = 0.017) and stressful life events (p = 0.012) as the most important predictors to worse response.ConclusionsThe improvement in all evaluations suggested that brief CBGT for pharmacotherapy-resistant patients could be an alternative as next-step strategy for residual symptoms with maintenance of the gains after 5 years as assessed across follow-up period. New strategies should be tried for resistant patients, such as those with dysthymia comorbidity, and some specific tool in order to cope with adverse events.

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Relationship of antecedent stressful life events to childhood and family history of anxiety and the course of panic disorder

Journal of Affective Disorders ◽

10.1016/s0165-0327(96)00081-x ◽

1996 ◽

Vol 41 (2) ◽

pp. 135-139 ◽

Cited By ~ 35

Author(s):

G Manfro

Keyword(s):

Family History ◽

Panic Disorder ◽

Life Events ◽

Stressful Life Events ◽

Stressful Life ◽

History Of ◽

Relationship Of

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Adverse life events and coping skills in panic disorder

Revista do Hospital das Clínicas ◽

10.1590/s0041-87812004000600005 ◽

2004 ◽

Vol 59 (6) ◽

pp. 337-340 ◽

Cited By ~ 6

Author(s):

Mariângela Gentil Savoia ◽

Márcio Bernik

Keyword(s):

Panic Disorder ◽

Life Events ◽

Stressful Life Events ◽

Rating Scale ◽

Coping Skills ◽

Stressful Events ◽

Panic Attacks ◽

Stressful Life ◽

Life Event ◽

The Impact

Research literature and clinical experience shows that panic patients are often able to identify stressors that preceded the onset of their first attacks. In this study we investigated the relation between life events, coping skills, and panic disorder. METHODS: Forty-tree panic patients were compared with 29 control subjects regarding the occurrence and the impact of stressful life events in a 1-year period preceding the onset of panic attacks using the Social Readjustment Rating Scale and London Life Event and Difficulty Schedule. Coping skills were measured using the Ways of Coping Questionnaire. RESULTS: No differences were observed between panic patients and controls regarding the number of reported stressful life events in the previous year. Panic patients compared to controls reported loss of social support as the most meaningful class of events significantly more often. In response to stressful situations, panic patients more often used coping skills judged as ineffective. CONCLUSIONS: The present study suggests that the type of life event and the coping skills used in response to them, more than the occurrence of stressful events itself, may be associated with the onset of panic disorder.

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