Predictors of short- and long-term avoidance in completers of inpatient group interventions for agoraphobia.

Abstract

BACKGROUND:

Little is currently known about predictors of follow-up outcome of psychological treatment of agoraphobia. In this study, we wished to examine predictors of short- and long-term avoidance after inpatient group interventions for agoraphobia.

METHODS:

Ninety-six (68%) of 141 agoraphobic patients (74% women) who had completed treatment in two open and one randomized controlled trial (RCT) were followed up 13 to 21 years after start of treatment.

RESULTS:

Major depression at pre-treatment predicted less short-term (up to one year after end of treatment) improvement in agoraphobic avoidance. Working and being married/cohabiting at pre-treatment predicted greater long-term (across one-year, two-year, and 13-21 years follow-up) improvement. In contrast, the duration of agoraphobia, amount of Axis I and II co-morbidity, being diagnosed with avoidant, dependent, and obsessive-compulsive personality disorder, and the use of antidepressants and benzodiazepines the month before intake to treatment, were unrelated to short-term as well as long-term outcome.

LIMITATIONS:

As many as 31.9% of the included patients did not attend long-term follow-up and the power of the study was limited. The long time period between the two and 13-21 year follow-ups is a limitation, in which it is difficult to assess what actually happened. Although all the patients received some form of CBT, there was variability among the treatments.

CONCLUSIONS:

The only short-term predictor identified represented a clinical feature, whereas the long-term predictors represented features of the patients' life situation. The limited power of the study precludes the inference that non-significant predictors are unrelated to follow-up outcome.

• Authors: Asle Hoffart, Tuva Øktedalen, Karol Svanøe, Liv M Hedley, Harold Sexton
• Journal: Journal of affective disorders (J Affect Disord) Vol. 181 Pg. 33-40 (Aug 01 2015) ISSN: 1573-2517 [Electronic] Netherlands
• PMID: 25917291 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier B.V. All rights reserved.

Topics

• Adult
• Agoraphobia (psychology, therapy)
• Avoidance Learning
• Clinical Trials as Topic
• Female
• Follow-Up Studies
• Humans
• Inpatients (psychology)
• Male
• Middle Aged
• Psychotherapy, Group
• Risk Factors
• Treatment Outcome