The development of agoraphobia in panic disorder: a predictable process?

Background: Panic attacks are conceptualized to be the central feature of both panic disorder without (PDU) and with agoraphobia (PDA). As a sizeable percentage of panic patients do not develop avoidance behavior, other factors than ‘panic attacks’, in general, must influence the different courses of the disorder. Method: We studied 84 outpatients suffering from PDU or PDA concerning different factors which were hypothesized to influence the development of agoraphobia. Results: ‘Earlier age of onset’, ‘fear of losing control’ and ‘chills or hot flushes’ turned out to correlate statistically significantly with PDA, while ‘chest pain or discomfort’ occurred more often in PDU. Limitations: The present study used retrospective data. Conclusions: The results of this study suggest that the development of agoraphobia in panic disorder is influenced by specific variables and is not a purely coincidental process.