title: Non-fearful panic disorder in gastroenterology.
abstract: 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.
authors.affiliation: Unità di Psicosomatica, IRCCS Ospedale De Bellis, Via della Resistenza, 70013 Castellana Grotte, Bari, Italy. porcellip@media.it
authors.forename: Piero
authors.initials: P
authors.lastname: Porcelli
authors.forename: Massimo
authors.initials: M
authors.lastname: De Carne
mesh_terms: 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
chemical_list: D014151:Anti-Anxiety Agents; D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride; D000525:Alprazolam