Impact of patient features on variations in anxiety symptoms in people with panic disorder

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Created On: 27/12/2022

A post-hoc study of PARADIES cluster randomised trial sought to investigate patient traits that could have an impact on how anxiety symptoms progressed over the course of a year.

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Key take away

A short intervention combining elements of cognitive behavioral therapy and case management is effective over 12 months in individuals suffering from panic disorder.

Background

A post-hoc study of PARADIES cluster randomised trial sought to investigate patient traits that could have an impact on how anxiety symptoms progressed over the course of a year.

Method

For quantifying the link of baseline characteristics (medication usage, clinical parameters, demographics) with alterations in anxiety symptoms (as estimated by Beck Anxiety Inventory [BAI] score), multiple linear regression was utilized. Confounders included treatment techniques (such as adherence to appointment dates). Before taking into account all independent factors in a multivariate final model, univariate connections between dependent and independent variables were investigated.

Using Akaike information criterion, step-wise selection of independent variables was done to determine the best model to explain alterations in BAI score. Utilizing the multivariate model, the therapy allocation (control vs. intervention) and independent variables were examined for interactions. These analyses were repeated individually for the intervention and control groups.

Result

Overall, 236 patients (56.3%) were enrolled from the initial trial (n = 419). Longer illness duration and greater anxiety symptom severity at baseline were substantially linked in multivariate model, receiving intervention, with improvements in anxiety symptom severity. On the other hand, baseline depression severity was connected to deterioration in anxiety symptoms.

Baseline severity of anxiety symptoms remained substantially linked with anxiety symptom alterations in both the arms. However, the control group revealed substantial relationships between severity of depression symptoms and illness duration with alterations in symptoms of anxiety, in stratified assessments.

Conclusion

In a wide spectrum of individuals with panic disorder with or without agoraphobia, encompassing those with baseline co-existing symptoms of depression and longer disease durations, a brief primary care-based exposure training combined with case management is beneficial.