[Paroxysmal anxiety crisis, viewpoint of the general practitioner]

According to general practitioners, anxiety disorders are amongst the commonest complaints in primary care. A survey carried out by réseau Sentinelle in June 1995 showed that acute panic attacks in general practice have given rise to 300,000 hours of consultations per year by general practitioners in France. Positive diagnosis raises practical difficulties in the surgery or at home, GPs could avoid such difficulties by using diagnosis criteria based on DSM IV and having knowledge of the patient's anticipation anxiety. In order to make the differential diagnosis, GPs will need to rule out any organic cause, notably cardiovascular pathology. Prior acquaintance with the patient will be of great help. A decision to treat is based on the frequency of acute panic attacks and on exchange of information with the psychiatrist. In return, the specialist will assist the GP in managing the patient's condition.