Panic episodes among patients with diabetes.
OBJECTIVE
The objective of this study was to examine the prevalence of panic episodes in persons with diabetes and the demographic, behavioral and clinical characteristics associated with panic symptoms in persons with diabetes.


METHODS
A survey mailed to 4385 patients with diabetes assessed recent experiences of panic episodes, depression, diabetes symptoms, quality of life, disability, smoking status and body mass index. Automated medical record data were used to measure diabetes treatment, hemoglobin A1c (Hb(A1c)) levels, diabetes complications and medical comorbidity.


RESULTS
One hundred ninety-three (4.4%) participants reported recent panic episodes, among whom 54.5% also met criteria for major depression. After accounting for the effects of depression, panic episodes were associated with higher Hb(A1c) values, increased diabetic complications and symptoms, greater disability and lower self-rated health and functioning.


CONCLUSIONS
Panic is strongly associated with decrements in disease status and functioning. Since panic is often comorbid with depression, efforts to address psychological disorders among persons with diabetes may need to pay increased attention to anxiety and mood disorders.
Ludman
Evette
E
Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. ludman.e@ghc.org
Katon
Wayne
W
Russo
Joan
J
Simon
Gregory
G
Von Korff
Michael
M
Lin
Elizabeth
E
Ciechanowski
Paul
P
Kinder
Leslie
L
D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology*; D004185:Disability Evaluation; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin