Evidence‐based guidelines for interpretation of the Panic Disorder Severity Scale
Open accessAbstract
BACKGROUND: The Panic Disorder Severity Scale (PDSS) is promising to be a standard global rating scale for panic disorder. In order for a clinical scale to be useful, we need a guideline for interpreting its scores and their changes, and for defining clinical change points such as response and remission. METHODS: We used individual patient data from two large randomized controlled trials of panic disorder (total n=568). Study participants were administered the PDSS and the Clinical Global Impression (CGI)--Severity and --Improvement. We applied equipercentile linking technique to draw correspondences between PDSS and CGI-Severity, numeric changes in PDSS and CGI-Improvement, and percent changes in PDSS and CGI-Improvement. RESULTS: The interpretation of the PDSS total score differed according to the presence or absence of agoraphobia. When the patients were not agoraphobic, score ranges 0-1 corresponded with "Normal," 2-5 with "Borderline," 6-9 with "Slightly ill," 10-13 with "Moderately ill," and 14 and above with "Markedly ill." When the patients were agoraphobic, score ranges 3-7 meant "Borderline ill," 8-10 "Slightly ill," 11-15 "Moderately ill," and 16 and above "Markedly ill." The relationship between PDSS change and CGI-Improvement was more linear when measured as percentile change than as numeric changes, and was indistinguishable for those with or without agoraphobia. The decrease by 75-100% was considered "Very much improved," that by 40-74% "Much improved," and that by 10-39% "Minimally improved." CONCLUSION: We propose that "remission" of panic disorder be defined by PDSS scores of five or less and its "response" by 40% or greater reduction.
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The average baseline score was within the moderate range for panic disorder symptoms.
“Still, the average baseline score was within the moderate range for panic disorder symptoms (Furukawa et al. 2009).”
From Internet‐Based Acceptance and Commitment Therapy With Interoceptive Exposure for Panic Disorder: A Randomized Controlled Trial and Working Alliance Analysis. (2026) · cites this paper as Furukawa et al. 2009
A prespecified analysis of a 40% reduction from baseline on PDSS based on observed data was used, which is equivalent to the participant being much improved, according to the guidelines by Furukawa et al.
“We also present a prespecified analysis of a 40% reduction from baseline on PDSS based on observed data, which is equivalent to the participant being much improved, according to the guidelines by Furukawa et al [36].”
From Individually Tailored Internet-Based Treatment for Young Adults and Adults With Panic Attacks: Randomized Controlled Trial (2012) · cites this paper as [36]
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- Authors
- Furukawa, T. A., Katherine Shear, M., Barlow, D. H., Gorman, J. M., Woods, S. W., Money, R., Etschel, E., Engel, R. R., & Leucht, S.
- Affiliations
- Nagoya City University (JP)
- Columbia University School of Social Work, New York, New York
- Boston University (US)
- Comprehensive NeuroScience, Inc., White Plains, New York
- Yale University (US)
- Ludwig-Maximilians-Universität München (DE)
- Technical University of Munich (DE)
- Corresponding author
- Furukawa, Toshi A.
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2008-11-12
- Volume
- 26
- Issue
- 10
- Pages
- 922-929
- ISSN
- 1091-4269 (ISSN-L)
- 1520-6394
- PMC
- PMC2760657
- OpenAlex
- W1995409814
- Cited by
- 163
- References
- 26
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 13 · 2023: 12 · 2022: 16 · 2021: 12 · 2020: 14 · 2019: 8 · 2018: 16 · 2017: 6 · 2016: 7 · 2015: 4 · 2014: 6 · 2013: 7 · 2012: 11
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH045966, R10MH045963, R01MH045963, MH045965, MH045966, R01MH045965, MH045964, R10MH045965, R01MH045964, MH045963)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- Panic Disorder Severity Scale, panic disorder, agoraphobia, Clinical Global Impression Scale, severity rating, equipercentile linking, score interpretation, individual patient data
- MeSH terms
- Adult, Agoraphobia, Antidepressive Agents, Tricyclic, Combined Modality Therapy, Female, Humans, Imipramine, Male, Middle Aged, Personality Assessment, Psychometrics, Reproducibility of Results, Multicenter Studies as Topic, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Panic Disorder, Treatment Outcome, Practice Guidelines as Topic, Evidence-Based Medicine
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