title: Clinical and subthreshold panic disorder.
abstract: BACKGROUND
  Panic disorder (PD) is a highly prevalent and disabling condition, and subthreshold cases may be even more prevalent. This study examined psychiatric comorbidities, work functioning, and health-care utilization of individuals with subthreshold panic. The purpose of this study was to add to the accumulating evidence of significant comorbidity and disability associated with subthreshold PD.
  
  
  METHODS
  Data are drawn from the Health Care for Communities study, a national household survey of the United States' adult, civilian, noninstitutionalized population (N=9585). Data assessing psychiatric disorders, employment and work productivity, and health-care utilization were collected. Seven categories of panic and subthreshold panic were created.
  
  
  RESULTS
  The prevalence of clinical and subthreshold panic in the general population was 40%. Subthreshold panic was associated with increased odds of several comorbid disorders, including depression, dysthymia, psychosis, generalized anxiety disorder, bipolar disorder, and alcohol and drug use disorders. Subthreshold panic was also associated with greater likelihood of health-care service utilization but not with the intensity of mental health services.
  
  
  CONCLUSIONS
  Psychiatric comorbidities and health-care utilization are common among patients with subthreshold panic. The relationship between varying degrees of panic symptomology and other mental health problems and indices of functioning impairment warrants further investigation. These results inform further research focusing on the course of subthreshold PD and its impact on quality of life.
authors.affiliation: The Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, California 90095-8346, USA. abystritsky@mednet.ucla.edu
authors.forename: Alexander
authors.initials: A
authors.lastname: Bystritsky
authors.forename: Lauren
authors.initials: L
authors.lastname: Kerwin
authors.forename: Noosha
authors.initials: N
authors.lastname: Niv
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Natoli
authors.forename: Natalie
authors.initials: N
authors.lastname: Abrahami
authors.forename: Ruth
authors.initials: R
authors.lastname: Klap
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wells
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Young
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D019564:Unnecessary Procedures / Q000706:statistics & numerical data; D014600:Utilization Review