This article discusses the validation of a module designed to evaluate the outcomes of clinical care for panic disorder The research utilized a longitudinal design to examine cross-sectional relationships and change over time within and between subjects. Baseline, follow-up, and test-retest data were collected on 73 patients. The initialfield test indicates that the Panic Outcomes Module measures outcomes and case-mix characteristics with acceptable levels of measurement error for group data The module's measure of change in panic severity demonstrated encouraging agreement with the structured interviewer's judgement of change. This module, completed in approximately 20 minutes, is short enough to incorporate into outpatient mental health settings. We recommend that providers and administrators interested in monitoring the outcomes of specialty care for panic disorder seek assistance from health services researchers to use the Panic outcomes module. Further research is needed to validate this module for use in primary care populations.
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References
1.
American Psychiatric Association
. (1987). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
2.
Ballenger, J. C.
, Burrows, G. D., DuPont, R. L., Jr., Lesser, I. M., Noyes, R., Jr., Pecknold, J. C., Rifkin, A., & Swinson, R. P. (1988). Alprazolam in panic disorder and agoraphobia: Results from a multi center trial: I. Efficacy in short-term treatment. Archives of General Psychiatry, 45,413-422.
3.
Barlow, D. H.
(1992). Cognitive-behavioral approaches to panic disorder and social phobia. Bulletin of the Menninger Clinic, 56(2 Suppl A), A14-A28.
4.
Beck, A. T.
(1988). Cognitive approaches to panic disorder: Theory and therapy. In S. Rachman & J. D. Maser (Eds.), Panic: Psychological perspectives (pp. 91-109). Hillsdale, NJ: Lawrence Erlbaum.
5.
Beck, A. T.
, Sokol, L., Clark, D. A., Berchick, R., & Wright, F. (1992). A crossover study of focused cognitive therapy for panic disorder. American Journal of Psychiatry, 149,778-783.
6.
Chambless, D. L.
, Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear in agoraphobics: The Body Sensations Questionnaire and the Agoraphobic Cognitions Questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097.
7.
Chambless, D. L.
, Caputo, G. C., Jasin, S. E., Gracely, E. J., & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour Research & Therapy, 23, 35-44.
8.
Chouinard, G.
, Annable, L., Fontaine, R., & Solyom, L. (1982). Alprazolam in the treatment of generalized anxiety and panic disorders: A double-blind placebo-controlled study. Psychopharmacology, 77,229-233.
9.
Derogatis, L. R.
, & Melisaratos, N. (1983). Thebrief symptom inventory: Anintroductory report. Psychological Medicine, 13, 595-605.
10.
Dillon, D. J.
, Lorman, J. M., Leibowitz, M. R., Fyer, A. J., & Klein, D. F. (1987). Measurement of lactate-induced panic and anxiety. Psychiatry Research, 20, 97-105.
11.
DiNardo, P. A.
, Moras, K., Barlow, D. H., Rapee, R. M., & Brown, T. A. (1990). Reliability of DSM-III-R anxiety disorders categories: Using the Anxiety Disorders Interview ScheduleRevised (ADIS-R). Archives of General Psychiatry, 50, 251-256.
12.
Hamilton, M.
(1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50-55.
13.
Hamilton, M.
(1960). A rating scale for depression. Journal of Neurology, Neurosurgery, & Psychiatry, 23, 56-62.
14.
Kessler, R. C.
, McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., Wittchen, H., & Kendler, K. S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the national comorbidity survey. Archives of General Psychiatry, 51, 8-19.
15.
Klerman, G. L.
, Weissman, M. M., Ouellette, R., Johnson, J., & Greenwald, S. (1991). Panic attacks in the community: Social morbidity and health care utilization. Journal of the American Medical Association, 265, 742-746.
16.
Klosko, J. S.
, Barlow, D. H., Tassinari, R., & Cerny, J. A. (1990). A comparison of Alprazolam and behavior therapy in treatment of panic disorder. Journal of Consulting and Clinical Psychology, 58,77-84.
17.
Leon, A. C.
, Shear, M. K., Portera, L., & Klerman, G. L. (1992). Assessing impairment in patients with panic disorder: The Sheehan Disability Scale. Social Psychiatry & Psychiatric Epidemiology, 27,78-82.
18.
Lydiard, R. B.
, Lesser, I. M., Ballenger, J. C., Rubin, R. T., Laraia, M., & Dupont, R. (1992). A fixed-dose study of alprazolam 2 mg, alprazolam 6 mg, and placebo in panic disorder. Journal of Clinical Psychopharmacology, 12, 96-103.
19.
Marks, I. M.
, & Mathews, A. M. (1979). Brief standard self-rating forphobic patients. Behaviour Research & Therapy, 17,263-267.
20.
McHomey, C., Lu, R., & Ware, J. (1991). 36-Item Short Form Survey: III. Preliminary tests in patients with medical and psychiatric conditions. Unpublished manuscript.
21.
Rapee, R. M., Craske, M. G., & Barlow, D. H. (1989, November). The Emotional Control Questionnaire. Poster session presented at American Association of Behavioral Therapies Annual Meeting, Washington, DC. Unpublished manuscript.
22.
Ravaris, C. L.
, Friedman, M. J., Hauri, P. J., & McHugo, G. J. (1991). A controlled study of alprazolam and propranolol in panic-disordered and agoraphobic outpatients. Journal of Clinical Psychopharmacology, 11, 344-350.
23.
Robins, L. N.
, & Helzer, J. E. (1982). Diagnostic interview schedule. Archives of General Psychiatry, 39, 1442-1445.
24.
Robins, L. N.
, Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E., Burke, J. D., & Regier, D. (1984). Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949-958.
25.
Shear, M. K., Sholomskas, D., & Cloitre, M. (1993). Information on reliability and validity of the MC-PAS. Unpublished manuscript.
