A 1-year follow-up study of coping in patients with panic disorder.

Abstract

We conducted a longitudinal study of methods used by patients with panic disorder to cope with stress, in order to investigate the characteristics of coping among these patients and to determine whether coping changes as therapy progresses and whether coping affects outcome. The Lazarus Type Stress Coping Inventory was performed on 43 patients with panic disorder and 315 normal subjects. The Stress Coping Inventory was repeated after 1 year therapy in the patients with panic disorder. Compared with normal subjects, panic disorder patients obtained significantly higher scores for emotional coping strategies (P =.04), and for seeking social support (P =.02) and escape-avoidance (i.e., wishful thinking) (P =.0008) as coping styles. On repeat assessment, these patients obtained significantly higher scores for cognitive coping strategies (P =.002), emotional coping strategies (P <.0001), planful problem solving (P =.02), confrontive coping (P =.002), seeking social support (P =.02), escape-avoidance (P <.0001), distancing (P =.002), and positive reappraisal (P =.001) than the normal subjects. A group x time interaction was significant for a self-controlling coping style (P =.01). On repeat assessment, the patients with a good outcome (Global Assessment of Functioning [GAF] score > 60) obtained a significantly higher score for self-controlling coping style, and the intractable patients (GAF score < or = 60) obtained a significantly lower score than on initial assessment. The results suggest that coping styles such as emotional coping strategies, seeking social support, and escape-avoidance are trait-dependent characteristics of patients with panic disorder. As therapy progressed, state-dependent changes, such as an increase in adaptive coping, were seen as well, and changes in coping also differed significantly based on outcome. These findings suggest that changing coping strategies in patients with panic disorder could be used as a goal of therapy.