Intrapatient agreement on phenomenology of panic attacks

Panic disorder is common in primary care settings and such a physician is often a patient's initial contact with the health care system. Previous work concerning the homogeneity of panic phenomenology across patients is contradictory. The purpose of this pilot study was to assess the intrapatient homogeneity of panic attacks and to examine associations between measures of homogeneity and physicians' confidence in the diagnosis. Ten patients meeting DSM-III-R criteria for panic disorder completed a diary documenting the symptomatic phenomenology of five consecutive panic attacks. In addition, the physician rated his diagnostic confidence for each patient. Patterns of symptoms and their sequences during panic showed good agreement within patients as did patterns of abatement and of presence of a precipitating event. The physician's diagnostic confidence was inversely related to agreement on symptom severity and variance of duration of an attack. This study suggests intrapatient homogeneity on most measures.