Panic disorder. Spectrum of severity and somatization

Area of Science:

• Psychiatry
• Clinical Psychology
• Epidemiology

Background:

• Panic disorder is a significant condition often presenting in primary care settings.
• Accurate screening tools are crucial for early identification and intervention.
• Existing diagnostic tools may miss cases with specific symptom presentations.

Purpose of the Study:

• To evaluate the effectiveness of the National Institute of Mental Health Diagnostic Interview Schedule (DIS) in screening for panic disorder.
• To assess the added value of four specific autonomic symptom screening questions to the DIS.
• To characterize patients with panic disorder and a subgroup with 'simple panic' in a primary care population.

Main Methods:

• One hundred ninety-five primary care patients were screened.
• The National Institute of Mental Health Diagnostic Interview Schedule (DIS) was utilized.
• Four additional questions targeting core autonomic symptoms of panic disorder were administered.

Main Results:

• A spectrum of panic disorder severity was identified, including a 'simple panic' subgroup.
• Patients with simple panic and panic disorder showed higher rates of phobias, avoidance, major depression, and anxiety/depression self-ratings compared to controls.
• The addition of four autonomic symptom questions increased the sensitivity of the DIS for identifying panic disorder.

Conclusions:

• Enhanced screening questions improve the detection of panic disorder in primary care.
• Patients experiencing panic attacks, even without meeting full diagnostic criteria, exhibit significant associated psychopathology.
• Focusing solely on cognitive aspects of anxiety may lead to underdiagnosis; autonomic symptoms are critical indicators.