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Does comorbidity of personality disorder influence treatment of panic disorder?

Publication |
2004

Abstract

The efficacy of the treatment of personality disorder was repeatedly been reported as less successful than the therapy of patients without personality disorder. Our study is designed to compare the short-term effectiveness of combination of cognitive behavioral therapy and pharmacotherapy in patient suffering with panic disorder with and without personality disorder.

Method: The aim of the study was to asses the 6th (efficacy) and 12th week (short follow up) efficacy of the 6 week therapeutic program designed for panic disorder and agoraphobia (SSRIs and CBT) in patients suffering with panic disorder and/or agoraphobia and comorbid personality disorder (29 patients) and panic disorder and/or agoraphobia without comorbid personality disorder (31 patients) according the ICD-10 research diagnostic criteria confirmed with MINI. They were regularly assessed in week 0, 2, 4, 6 and 12 by an independent reviewer on the CGI (Clinical Global Improvement) for severity and change, PDSS (Panic Disorder Severity Scale), HAMA (Hamilton Anxiety Rating Scale), SDS (Sheehan Disability Scale), HDRS (Hamilton Depression Rating Scale), and in self-assessments BAI (Beck Anxiety Inventory) and BDI (Beck Depression Inventory).

Results: Patients of both two groups improved in all assessment instruments. A combination of CBT and pharmacotherapy proved to be the effective treatment of patients suffering with panic disorder and/or agoraphobia with or without comorbid personality disorder.

The 12th week treatment efficacy in the patients with panic disorder without personality disorder had been showed significantly better compared with the group with panic disorder comorbid with personality disorder in CGI and specific inventory for panic disorder - PDSS. Also the scores in depression inventories HDRS and BDI showed significantly higher degrease during the treatment in the group without personality disorder.

But the treatment effect between groups did not differ in objective general anxiety scale HAMA, and subjective general anxiety scales BAI