Effect of resilience on clinical symptoms and treatment response in panic disorder

AIM: Resilience has important effects on the course of illness, severity of symptoms, level of functioning, treatment response and quality of life. It has been shown that adverse experiences during childhood and the coping mechanisms used against them are important in determining the level of resilience. The effect of resilience on severity of symptoms and the quality of life has been reported on many studies conducted on patients with different mental disorders. The aim of our study is to investigate the effect of childhood trauma and the coping mechanisms on resilience and to discover the relationship between the level of resilience and symptom severity, treatment response, quality of life in panic disorder (PD). METHODS: 35 patients with panic disorder and 33 healthy volunteers matched by age, sex and years of education has been included in the study. 17 of the patients with panic disorder also have the diagnosis of agoraphobia. The Structured Clinical Interview for DSM-IV Axis I Disorders, Clinical Version(SCID-IV/CV), Coping Orientation to Problems Experienced Scale (COPE), Childhood Trauma Questionnaire (CTQ), Hamilton Depression Rating Scale (HAM-D), Panic Disorder Severity Scale, Resilience Scale for Adults (RSA), Hamilton Anxiety Rating Scale (HAM-A), World Health Organization Quality-of-Scale, Short form (WHOQOL-BREF) have been applied to all participants. RESULTS: Patients and the controls were matched by age, sex and years of education. Compared with control group, patients with PD have higher scores in CTQ physical abuse subscale and lower scores in WHOQOL-BREF in total and in general health, physical health and psychological health subscales. As a difference from the healthy participants, RSA total score of patients with PD was found to be correlated with CTQ physical abuse, sexual abuse and physical neglect subscales' scores, with WHOOQOL-BREF general health, physical health subscales' scores and with COPE scores. Severity of disorder was correlated with RSA social resources subscale and RSA structured style scores were significantly changed after treatment. CONCLUSION: Patient with PD differs from healthy controls by their satisfaction about their physical health. Childhood trauma and coping mechanisms are thought to play an important role in the capacity of maintaining mental resilience and in determining symptom severity in patients with PD.