Non-fearful panic disorder: a variant of panic in medical patients?
Is it possible to have panic attacks without fear? Beitman et al. reported that 32%-41% of panic disorder (PD) patients seeking treatment for chest pain have non-fearful panic disorder (NFPD). To replicate and extend this work on NFPD, the authors compared NFPD patients (N = 48), PD patients (N = 60), and No-PD patients (N = 333) at the time of an emergency department visit and follow-up approximately 2 years later. The authors compared comorbid Axis I diagnoses, panic attack symptoms, and scores on self-report measures. A significantly greater proportion of PD patients had comorbid generalized anxiety disorder and agoraphobia than NFPD patients. NFPD patients had self-report scores that were between no-PD and PD patients or similar to no-PD patients, with the exception of the Beck Depression Inventory. At follow-up, NFPD patients, like PD patients, were still symptomatic and had either not improved or had worsened according to scores on all self-report measures. NFPD should be recognized as a variant of PD, both because of its high prevalence in medical settings and its poor prognosis.
Fleet
R P
RP
Research Center, Montreal Heart Institute, Department of Psychology, Université du Québec à Montréal, Canada.
Martel
J P
JP
Lavoie
K L
KL
Dupuis
G
G
Beitman
B D
BD
D000328:Adult; D000368:Aged; D000379:Agoraphobia / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D002637:Chest Pain / Q000523:psychology*; D015897:Comorbidity; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010200:Panic; D016584:Panic Disorder / Q000175:diagnosis* / Q000523:psychology; D011379:Prognosis