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The British Journal of General Practice logoLink to The British Journal of General Practice
. 1994 Aug;44(385):352–356.

Controlled comparison of the characteristics of patients with panic disorder.

R J Simpson 1, T Kazmierczak 1, K G Power 1, D M Sharp 1
PMCID: PMC1238951  PMID: 8068393

Abstract

BACKGROUND. Increased general practice attendance rates have been associated with the diagnosis of mental illness but panic disorder has not been specifically investigated in this respect. In addition, studies have failed adequately to assess type and frequency of secondary care referral and patterns of psychotropic prescription in patients with panic disorder in relation to matched controls. AIM. This study set out to compare subjects with panic disorder with age and sex matched controls on measures of general practice consultation rate; psychotropic and non-psychotropic drug use; referral to secondary care, laboratory and radiological tests and hospital admissions; history of illness and complaints; and psychiatric comorbidity. METHOD. The study was carried out in nine practices in the Forth Valley area. One hundred patients with panic disorder, previously diagnosed using DSM III-R criteria, were identified and matched by age and sex with controls. Data were collected by review of general practice case notes. RESULTS. Subjects with panic disorder had significantly higher rates of general practice consultation over the 10 year period prior to DSM III-R diagnosis of panic disorder than controls. Subjects with panic disorder had also been prescribed a significantly greater number of psychotropic and non-psychotropic medications over this period, had had more secondary care investigations and had higher rates of mainly minor illness and related complaints than controls. High comorbidity of panic disorder with depression which had been diagnosed over the 10 year period prior to DSM III-R diagnosis of panic disorder was found. CONCLUSION. The results of this study describe a population of subjects with panic disorder who are long-term heavy users of primary care services. The results also suggest an association between panic disorder and both minor illness and psychiatric comorbidity over the 10 year period prior to DSM III-R diagnosis of panic disorder.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blakey R. Psychological treatment in general practice: its effect on patients and their families. J R Coll Gen Pract. 1986 May;36(286):209–211. [PMC free article] [PubMed] [Google Scholar]
  2. Boyd J. H. Use of mental health services for the treatment of panic disorder. Am J Psychiatry. 1986 Dec;143(12):1569–1574. doi: 10.1176/ajp.143.12.1569. [DOI] [PubMed] [Google Scholar]
  3. Clouse R. E. Anxiety and gastrointestinal illness. Psychiatr Clin North Am. 1988 Jun;11(2):399–417. [PubMed] [Google Scholar]
  4. Coryell W., Noyes R., Clancy J. Excess mortality in panic disorder. A comparison with primary unipolar depression. Arch Gen Psychiatry. 1982 Jun;39(6):701–703. doi: 10.1001/archpsyc.1982.04290060051010. [DOI] [PubMed] [Google Scholar]
  5. Coryell W. Panic disorder and mortality. Psychiatr Clin North Am. 1988 Jun;11(2):433–440. [PubMed] [Google Scholar]
  6. Dotevall G., Groll E. Controlled clinical trial of mepiprazole in irritable bowel syndrome. Br Med J. 1974 Oct 5;4(5935):16–18. doi: 10.1136/bmj.4.5935.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Goldberg D., Bridges K. Screening for psychiatric illness in general practice: the general practitioner versus the screening questionnaire. J R Coll Gen Pract. 1987 Jan;37(294):15–18. [PMC free article] [PubMed] [Google Scholar]
  8. Haines A. P., Imeson J. D., Meade T. W. Phobic anxiety and ischaemic heart disease. Br Med J (Clin Res Ed) 1987 Aug 1;295(6593):297–299. doi: 10.1136/bmj.295.6593.297. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hankin J. R., Steinwachs D. M., Regier D. A., Burns B. J., Goldberg I. D., Hoeper E. W. Use of general medical care services by persons with mental disorders. Arch Gen Psychiatry. 1982 Feb;39(2):225–231. doi: 10.1001/archpsyc.1982.04290020077014. [DOI] [PubMed] [Google Scholar]
  10. Irwin W. G., Cupples M. E. A survey of psychotropic drug prescribing. J R Coll Gen Pract. 1986 Aug;36(289):366–368. [PMC free article] [PubMed] [Google Scholar]
  11. Jefferson J. W. Biologic systems and their relationship to anxiety. Summary. Psychiatr Clin North Am. 1988 Jun;11(2):463–472. [PubMed] [Google Scholar]
  12. Katon W. Panic disorder and somatization. Review of 55 cases. Am J Med. 1984 Jul;77(1):101–106. doi: 10.1016/0002-9343(84)90443-1. [DOI] [PubMed] [Google Scholar]
  13. Klein D. F., Gorman J. M. A model of panic and agoraphobic development. Acta Psychiatr Scand Suppl. 1987;335:87–95. doi: 10.1111/j.1600-0447.1987.tb07753.x. [DOI] [PubMed] [Google Scholar]
  14. Marks I. M. Epidemiology of anxiety. Soc Psychiatry. 1986;21(4):167–171. doi: 10.1007/BF00583996. [DOI] [PubMed] [Google Scholar]
  15. Marks I., O'Sullivan G. Drugs and psychological treatments for agoraphobia/panic and obsessive-compulsive disorders: a review. Br J Psychiatry. 1988 Nov;153:650–658. doi: 10.1192/bjp.153.5.650. [DOI] [PubMed] [Google Scholar]
  16. Ramesh C., Yeragani V. K., Balon R., Pohl R. A comparative study of immune status in panic disorder patients and controls. Acta Psychiatr Scand. 1991 Oct;84(4):396–397. doi: 10.1111/j.1600-0447.1991.tb03166.x. [DOI] [PubMed] [Google Scholar]
  17. Sanderson W. C., DiNardo P. A., Rapee R. M., Barlow D. H. Syndrome comorbidity in patients diagnosed with a DSM-III-R anxiety disorder. J Abnorm Psychol. 1990 Aug;99(3):308–312. doi: 10.1037//0021-843x.99.3.308. [DOI] [PubMed] [Google Scholar]
  18. Simpson R. J., Power K. G., Wallace L. A., Butcher M. H., Swanson V., Simpson E. C. Controlled comparison of the characteristics of long-term benzodiazepine users in general practice. Br J Gen Pract. 1990 Jan;40(330):22–26. [PMC free article] [PubMed] [Google Scholar]
  19. Stein M. B., Uhde T. W. Panic disorder and major depression. A tale of two syndromes. Psychiatr Clin North Am. 1988 Jun;11(2):441–461. [PubMed] [Google Scholar]
  20. Whitehouse C. R. A survey of the management of psychosocial illness in general practice in Manchester. J R Coll Gen Pract. 1987 Mar;37(296):112–115. [PMC free article] [PubMed] [Google Scholar]
  21. Wittchen H. U., Essau C. A., Krieg J. C. Anxiety disorders: similarities and differences of comorbidity in treated and untreated groups. Br J Psychiatry Suppl. 1991 Sep;(12):23–33. [PubMed] [Google Scholar]

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