The occurrence of a prodrome of generalized anxiety in panic disorder

Twenty-eight percent of 32 panic disordered patients had a prodrome of generalized anxiety symptoms lasting a median of 5 years before the occurrence of their first panic attack. Patients with a generalized anxiety prodrome were similar to the nonprodrome patients for 55 tested clinical variables, including individual anxiety symptoms, response to treatment, severity of illness, and most aspects of family history. It appears that a prodrome of generalized anxiety symptoms is a variation of the presentation of panic disorder. Initially, these patients may be misdiagnosed as having generalized anxiety disorder (GAD) and contribute to the heterogeneity of GAD.