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Subtypes of panic attacks and ICD-9 classification.

W Maier, R Buller, A Sonntag

    European Archives of Psychiatry and Neurological Sciences
    |January 1, 1986
    PubMed
    Summary
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    The International Classification of Diseases, Ninth Revision (ICD-9) cannot accurately identify patients with panic disorder. Current ICD-9 codes are too broad, necessitating classification modifications for better diagnostic accuracy in panic disorder.

    Area of Science:

    • Psychiatry
    • Medical Diagnostics
    • Classification Systems

    Background:

    • Panic disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), lacks a direct equivalent in the International Classification of Diseases, Ninth Revision (ICD-9).
    • Accurate diagnostic classification is crucial for patient identification, treatment, and research.

    Purpose of the Study:

    • To evaluate the ability of ICD-9 codes to identify patients experiencing panic attacks.
    • To assess the validity of ICD-9 diagnostic boundaries in relation to panic disorder and related conditions.

    Main Methods:

    • Recruited 97 patients experiencing three panic attacks within three weeks from multiple medical centers.
    • Independently classified patients using both DSM-III criteria for panic disorder and ICD-9 diagnostic codes.

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  • Utilized symptomatology and cluster analysis to validate diagnostic boundaries.

    • Main Results:

    • ICD-9 diagnoses for patients with panic attacks were widely distributed across various categories, preventing reliable identification.
    • Anxiety state, affective psychosis, and depressive neurosis were the most common ICD-9 diagnoses assigned.
    • A clear distinction was established between affective psychosis and anxiety state/depressive neurosis based on symptomatology and cluster analysis.
    • The differentiation between anxiety state and depressive neurosis could not be validated through the methods used.

    Conclusions:

    • The current ICD-9 classification system is inadequate for identifying patients with panic disorder.
    • Proposed modifications to ICD-9 classifications are necessary to improve diagnostic accuracy for panic disorder and related conditions.
    • Further research is needed to refine the boundaries between anxiety state and depressive neurosis within diagnostic systems.