Panic disorder in primary care: biopsychosocial differences between recognized and unrecognized patients

Area of Science:

• Psychiatry
• Primary Care Medicine
• Clinical Psychology

Background:

• Primary care physicians (PCPs) often diagnose depression in more symptomatic patients.
• Panic disorder diagnosis in primary care can be challenging due to symptom overlap and physician workload.

Purpose of the Study:

• To compare baseline characteristics of panic disorder patients recruited via waiting room screening versus PCP referral.
• To investigate factors influencing PCP recognition and referral of panic disorder patients.

Main Methods:

• A randomized effectiveness study involving primary care patients with panic disorder.
• Comparison of demographic and clinical data between screen-identified (n=69) and PCP-referred (n=41) patients.

Main Results:

• Referred patients reported more frequent, intense panic attacks and anticipatory anxiety.
• Screen-identified patients had higher medical illness burden and worse physical functioning.
• No significant differences were observed in depression, anxiety sensitivity, phobic avoidance, or disability.

Conclusions:

• Physician recognition of panic disorder appears linked to prominent physical symptoms like panic attacks.
• Patients presenting with less severe physical symptoms or co-occurring medical conditions may be less likely to be identified by PCPs.
• The findings support the utility of population-based screening for panic disorder in primary care settings.