Factors affecting the threshold for seeking care: the Panic Attack Care-Seeking Threshold (PACT) Study.
BACKGROUND
This study was conducted to explore the phenomenon of seeking medical care for panic attacks and to identify factors associated with seeking care.


METHODS
A community sample of adults was screened using the Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition. Subjects who had experienced panic attacks participated in a structured interview concerning their health care access and utilization, panic characteristics, comorbidity, illness attitudes and perceptions, and family characteristics.


RESULTS
Forty-one percent of the subjects had not sought medical care for their panic attacks. Having to get someone to drive (RR [relative risk] = 1.8; P = 0.0026), inability to work because of panic (RR = 1.6; P = 0.0054), and a high treatment experience score on the Illness Attitude Scales (RR = 1.5; P = 0.034) independently predicted seeking care. Seeking support was also significantly associated with seeking care (t = -4.05; P = 0.0001). Care seekers tended to have more severe symptoms, stronger symptom perceptions, and more bodily preoccupation and to abuse drugs more frequently. Seeking care was not influenced by sex, race or ethnicity, stress, psychiatric comorbidity, family function, social support, or access to health care.


CONCLUSIONS
Nearly one-half of persons with panic attacks do not seek care for their attacks. Those who seek care differ from those who do not in ways that have important implications for the understanding of this illness.
Realini
J P
JP
Department of Family Practice, University of Texas Health Science Center, San Antonio 78284-7795.
Katerndahl
D A
DA
D000328:Adult; D000704:Analysis of Variance; D001334:Automobile Driving; D004651:Employment; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000150:complications / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012306:Risk; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000150:complications