May 1988

The Course of Panic Attacks and Agoraphobia

Author Affiliations

Department of Psychiatry University of Mainz Untere Zahlbacher Straβe 8 D-6500 Mainz West Germany

Arch Gen Psychiatry. 1988;45(5):501. doi:10.1001/archpsyc.1988.01800290123014

To the Editor.—  Breier et al,1 in the November 1986 issue of the ARCHIVES, reported retrospective data on the course of panic disorder and agoraphobia. A major finding was the chronicity of anticipatory anxiety, generalized anxiety, agoraphobia, and frequent panic attacks. The problem with these findings is that the sample may be biased for chronicity: 28 of the 60 patients had a history of anxiety disorders longer than ten years. It may be that these patients came to the research treatment program because their conditions were refractory to treatment received in a primary care setting. Patients with a more favorable course that remits during treatment often never see a psychiatrist. Previous follow-up studies2 of anxiety disorders are similarly biased; the retrospective method may increase this bias. The hypothesis of chronicity in anxiety disorders therefore needs support from prospective studies in population samples. We had the opportunity to perform

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