Panic in the emergency room.
OBJECTIVE
This paper examines the relation between coronary artery disease (CAD) and panic disorder (PD), discusses the implications of this relation to the general medical system, and suggests future assessment and intervention strategies for emergency departments.


METHODS
We reviewed the literature on CAD and PD using Medline and PsycINFO.


RESULTS
PD is more expensive to our nonpsychiatric, general medical system than any other psychiatric condition. The main reason for PD patients' continued use of general medicine for their psychological symptoms is that their PD remains undiagnosed. In the emergency room (ER), PD patients with chest pain have their PD go undiagnosed about 98% of the time. By having ERs implement specific assessment and intervention strategies for patients presenting with chest pain, the savings to the general medical system could be substantial.


CONCLUSIONS
By improving recognition of PD in the ER, there is the potential to generate large savings in general medical care. With the availability of empirically supported or effective psychological and pharmacologic treatments for PD, appropriately diagnosing and subsequently treating patients with PD may prevent them from experiencing many years of disability and higher rates of fatal coronary events.
Lynch
Patrick
P
Department of Psychology, Foothills Medical Centre, Departments of Psychology and Psychiatry, University of Calgary, Calgary, Alberta. patrick.lynch@calgaryhealthregion.ca
Galbraith
Kim M
KM
D002637:Chest Pain / Q000175:diagnosis / Q000191:economics; D003362:Cost-Benefit Analysis; D003951:Diagnostic Errors; D004632:Emergency Medical Services; D017048:Health Care Costs; D006801:Humans; D016584:Panic Disorder / Q000175:diagnosis / Q000191:economics / Q000209:etiology*