Is it possible to prevent relapse in panic disorder?

This is the authors' abstract. We don't add key points for this paper.

Up to 33.7% of the population is affected by an anxiety disorder during their lifetime according to large populationbased surveys. Panic disorder (PD) has a lifetime prevalence of 1.6% to 5.2%, while the lifetime prevalence of agoraphobia is 0.8% to 2.6% in these studies [1]. PD is associated with functional, occupational, and quality of life impairments. Its economic impact on society is also significant. PD has been associated with suicide attempts, greater use of health care services and decreased work productivity [2]. Many treatments are available for PD and agoraphobia, including pharmacological treatments, cognitive-behavioral therapy (CBT)-based treatments, neurostimulation and physical exercise [2,3]. Despite all treatment options, only 64.5% of patients achieve remission in the first year of treatment, and 21.4% of PD patients have recurrences of panic attacks before completing one year of remission [4]. Typically, PD has a waxing and waning course. In the study from Andersch & Hetta [5], patients with PD were followed for 15 years after a clinical trial with imipramine and alprazolam. At the end of the followup phase, they found that 51% still presented with panic symptoms, 18% met the diagnostic criteria for PD and 20% had agoraphobia. Relapse after the end of a well-conducted treatment seems to be a common phenomenon regarding both pharmacological and psychological treatments.