A 1-year follow-up study of chest-pain patients with and without panic disorder.
OBJECTIVE
The aims of this study were to (a) study the persistence of panic disorder (PD); (b) investigate the association between PD at baseline and outcome [chest pain, psychiatric morbidity, health care utilization, suicidal thoughts, work impairment and health-related quality of life (HRQOL)]; (c) study the course of pain, distress, symptom attribution and HRQOL; and (d) describe treatment and perceived treatment needs of patients with PD.


METHODS
A 1-year follow-up study of 199 chest-pain patients referred to cardiac outpatient investigation was completed. Assessments included Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID), Short-Form McGill Pain Questionnaire, Symptom Checklist-90-Revised, the Illness Attitude Scales, the 36-item Short-Form Health Survey and a chest-pain questionnaire.


RESULTS
At follow-up, 57 of the 153 patients reassessed with the SCID suffered from PD. Forty-three of the 55 patients (78%) who were diagnosed with PD at baseline still suffered from PD at follow-up. PD at baseline was associated with pain persistence, psychiatric morbidity (current major depression, pain disorder and simple phobia), significantly higher scores on psychological distress, hypochondriasis, negative outcome expectation, lower scores on seven of the eight dimensions of HRQOL and more general practitioner consultations. Only 6% of the patients with PD used effective treatment, and 3% reported a treatment need at follow-up.


CONCLUSIONS
Despite chronic distress and impairment, we found significant undertreatment of PD, which needs to be addressed in future studies.
Dammen
Toril
T
Department of Psychiatry, Ullevaal University Hospital, N-0407 Oslo, Norway. toril.dammen@medisin.uio.no
Bringager
Christine Bull
CB
Arnesen
Harald
H
Ekeberg
Oivind
O
Friis
Svein
S
D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires