Panic-related outcomes in patients with a personal physician.
OBJECTIVE
Although having a regular source of care is associated with positive health behaviors, its effect in specific disorders is not known. This study assessed differences in outcomes of patients with panic attacks, including symptoms, health care utilization, and treatment for panic symptoms based on the presence and specialty of a self-defined personal physician.


METHODS
In this community-based study, 97 subjects with Diagnostic and Statistical Manual, Third Edition, Revised (DSM-IIIR) panic attacks were interviewed concerning total and recent health care utilization for panic symptoms, total and current treatment for panic symptoms, and panic-related outcomes such as quality of life, psychiatric symptoms, work disability, substance abuse, and perceived control.


RESULTS
Although the absence of a personal family physician was not related to outcomes, the specialty of the personal physician was associated with significant differences in recent health care utilization and treatment for panic and in panic-related outcomes. Having a mental health provider was associated with more utilization and treatment but worse outcomes. However, such differences could generally be explained by differences in preexisting psychiatric disorders and the severity of panic symptoms.


CONCLUSIONS
Compared with having a mental health provider, having a family physician was associated with fewer recent ambulatory visits, particularly to mental health settings, and less-frequent current use of prescription, over-the-counter, or illicit drugs for panic. Yet, when corrected for panic severity and prior mental disorders, there was no difference in these outcomes.
Katerndahl
David
D
Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, 78229, USA. katerndahl@uthscsa.edu
D000328:Adult; D005194:Family Practice / Q000592:standards*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008875:Middle Aged; D016584:Panic Disorder / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D010818:Practice Patterns, Physicians'; D011570:Psychiatry / Q000592:standards*; D012720:Severity of Illness Index; D013781:Texas; D016896:Treatment Outcome; D000078329:Workforce