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Panic in the emergency room.

Patrick Lynch1, Kim M Galbraith

  • 1Department of Psychology, Foothills Medical Centre, Departments of Psychology and Psychiatry, University of Calgary, Calgary, Alberta. patrick.lynch@calgaryhealthregion.ca

Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie
|August 5, 2003
PubMed
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Undiagnosed panic disorder (PD) in emergency rooms leads to significant costs. Improving PD recognition in ERs can reduce healthcare expenses and prevent long-term disability and fatal events.

Area of Science:

  • Cardiology
  • Psychiatry
  • Health Economics

Background:

  • Panic disorder (PD) is a significant contributor to healthcare costs within the general medical system.
  • Undiagnosed PD often leads patients to seek care for somatic symptoms in non-psychiatric settings.
  • Emergency departments (ERs) frequently miss PD diagnoses in patients presenting with chest pain.

Purpose of the Study:

  • To examine the relationship between coronary artery disease (CAD) and panic disorder (PD).
  • To discuss the implications of this relationship for the general medical system.
  • To propose assessment and intervention strategies for emergency departments.

Main Methods:

  • A comprehensive literature review was conducted.
  • Databases searched included Medline and PsycINFO.

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  • The review focused on studies investigating CAD and PD.

    • Main Results:

    • Panic disorder is the most expensive psychiatric condition for the nonpsychiatric medical system.
    • A primary driver of cost is the high rate of undiagnosed PD in general medical settings.
    • Approximately 98% of PD patients with chest pain in ERs remain undiagnosed.

    Conclusions:

    • Enhanced recognition of PD in ERs offers substantial potential for cost savings in general medical care.
    • Effective psychological and pharmacological treatments for PD are available.
    • Accurate diagnosis and treatment of PD can mitigate long-term disability and reduce the risk of fatal coronary events.