Skip to main content
Log in

Avoidance behaviour: A predictor of the efficacy of pharmacotherapy in panic disorder?

  • Original Articles
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Summary

The impact of the avoidance behaviour on the psychopharmacological treatment of panic disorder was explored in the Cross National Collaborative Panic Study (n=1134 patients); in this double blind randomized trial alprazolam, imipramine and placebo were compared during an 8-week treatment period. Patients with extensive avoidance behaviour (agoraphobia) had the most profit from the active drugs. Counter expectancy these specific drug effects were most pronounced in avoidance behaviour. Active drugs (in particular imipramine) were especially more effective than placebo if the patients presented with associated avoidance behaviour. The results suggest that agoraphobia defines more a particular type of anxiety disorder overlapping with panic disorder than merely a severe state of panic disorder.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • American Psychiatric Association (1987) Diagnostic Criteria from DSM-III-R

  • Ballenger JC, Burrows GD, Dupont RL (1988) Alprazolam in panic disorder and agoraphobia: I. Efficacy in short-term treatment. Arch Gen Psychiatry 45:413–422

    PubMed  Google Scholar 

  • Cross-National Collaborative Panic Study. Second Phase Investigators (1991) Drug treatment of panic disorder: Comparative efficacy of alprazolam, imipramine and placebo. Br J Psychiatry, in press

  • Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32:50–55

    PubMed  Google Scholar 

  • Kendall MG, Stuart A (1983) The Advanced Theory of Statistics. Vol 2, 4th ed., Griffin, London

    Google Scholar 

  • Klein DF, Ross DC, Cohen D (1987) Panic and avoidance in agoraphobia: Application of path analysis to treatment studies. Arch Gen Psychiatry 44:377–385

    PubMed  Google Scholar 

  • Klein DF, Klein HM (1989) The Utility of the Panic Disorder Concept. Eur Arch Psychiatr Neurol Sci 238:268–279

    Google Scholar 

  • Klerman GI (1988) Overview of the cross-national collaborative panic study. Arch Gen Psychiatry 45:407–412

    PubMed  Google Scholar 

  • Lesser IM, Rubin RT, Pecknold JC, Rifkin A, Swinson RP, Lydiard B, Burrous GD, Noyes R, Du Pont RL Jr (1988) Secondary depression in panic disorder and agoraphobia. Arch Gen Psychiatry 45:437–443

    PubMed  Google Scholar 

  • Maier W, Philipp M, Buller R (1988) The value structured clinical interview. Arch Gen Psychiatry 45:963–964

    PubMed  Google Scholar 

  • Maier W, Rosenberg R, Argyle N, Buller R, Roth M, Brandon S, Benkert O (1989) Avoidance Behaviour and Major Depression in Panic Disorder: A Report from the Cross-National Collaborative Panic Study. Psychiatric Developments 2:123–142

    Google Scholar 

  • Marks IM (1983) Are there Anticompulsive or Antiphobic Drugs? Review of the Evidence. Br J Psychiatry 143:338–347

    PubMed  Google Scholar 

  • Marks IM, O'Sullivan G (1989) Anti-anxiety drug and psychological treatment effects in agoraphobia/panic and obsessive-compulsive disorders. In: P. Tyrer (ed) Psychopharmacology of Anxiety, Oxford.

  • Mavissakalian M (1982) Pharmacological treatment of anxiety disorders. J Clin Psychiatry 43:487–491

    PubMed  Google Scholar 

  • Noyes R Jr, Crowe RR, Harris EL, Hamra BJ, McChesney CM and Chaudhry DR (1986) Relationship between panic disorder and agoraphobia: a family study. Arch Gen Psychiatry 43:227–232

    PubMed  Google Scholar 

  • Roth M, Argyle N (1988) Anxiety, panic and phobic disorders: an overview. J Psychiatric Res, Suppl. I:33–54

    Google Scholar 

  • Spitzer RL, Williams JBW (1988) Revised diagnostic criteria and a new structured interview for diagnosing anxiety disorders. J Psychiatrie Res 22:55–85

    Google Scholar 

  • World Health Organisation (1989) ICD-10, Chapter V, Criteria for Research. WHO, Geneva

    Google Scholar 

  • Zitrin CM, Klein DF, Woerner MG, Ross DC (1983) Treatment of phobias. 1. Comparison of imipramine hydrochloride and placebo. Arch Gen Psychiatry 40:125–138

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maier, W., Roth, M., Argyle, N. et al. Avoidance behaviour: A predictor of the efficacy of pharmacotherapy in panic disorder?. Eur Arch Psychiatry Clin Nuerosci 241, 151–158 (1991). https://doi.org/10.1007/BF02219714

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02219714

Keywords

Navigation