Non-fearful panic disorder in gastroenterology.
BACKGROUND
Nonfearful panic disorder (NFPD) is a panic condition masked under the appearance of somatic symptoms only, without the component of fear, and it represents a challenging diagnostic task.


METHODS
This is the first case report of NFPD in a male patient with acute gastric pain and gastrointestinal disease (atrophic gastritis and H. pylori infection).


RESULTS
The patient showed atypical panic symptoms and demoralization on the Diagnostic Criteria for Psychosomatic Research screening. He was successfully treated with anti-panic medication and cognitive-behavioral therapy.


CONCLUSIONS
The case report shows that accurate psychosomatic assessment may help clinicians avoid diagnostic delay, prevent the administration of unnecessary medications, and give patients more appropriate treatment.
Porcelli
Piero
P
Unità di Psicosomatica, IRCCS Ospedale De Bellis, Via della Resistenza, 70013 Castellana Grotte, Bari, Italy. porcellip@media.it
De Carne
Massimo
M
D000208:Acute Disease; D000328:Adult; D000525:Alprazolam / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003511:Cyclohexanols / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005239:Fear / Q000523:psychology*; D005500:Follow-Up Studies; D005757:Gastritis, Atrophic / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology* / Q000523:psychology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D016584:Panic Disorder / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D000069470:Venlafaxine Hydrochloride
D014151:Anti-Anxiety Agents; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride; D000525:Alprazolam