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Agoraphobia With and Without Panic Disorder: A 20-Year Follow-up of Integrated Exposure and Psychodynamic Therapy

Hoffart, Asle PhD; Hedley, Liv M. PhD; Svanøe, Karol MSW; Langkaas, Tomas Formo CandPsychol; Sexton, Harold MD

The Journal of Nervous and Mental Disease: February 2016 - Volume 204 - Issue 2 - p 100–107
doi: 10.1097/NMD.0000000000000419
Original Articles

The aim of the current study was to compare the 20-year outcome in panic disorder with agoraphobia (PD with AG) and agoraphobia without panic disorder (AG without PD) patients after inpatient psychological treatment. Of 53 eligible patients having completed a medication-free integrated exposure and psychodynamic treatment, 38 (71.7%)—25 PD with AG and 13 AG without PD patients—attended 20-year follow-up. AG without PD patients improved less than PD with AG patients did on primary outcome measures. In the PD with AG group, there were large uncontrolled effect sizes (<−2.30). More of the AG without PD patients had avoidant personality disorder at pretreatment, but the presence of this disorder did not predict outcome. The follow-up results support that PD with AG and AG without PD are two different disorders. The results also suggest that the very long-term outcome in PD with AG patients is excellent for this integrated treatment.

*Research Institute, Modum Bad, Vikersund; †Department of Psychology, University of Oslo, Oslo; and ‡Vestfold University College, Tønsberg, Norway.

Send reprint requests to Asle Hoffart, PhD, Research Institute, Modum Bad, N-3370 Vikersund, Norway. E-mail:

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