Dyspnea and panic among patients with newly diagnosed non-small cell lung cancer.
BACKGROUND
Among patients with lung cancer, dyspnea is associated with psychological distress, fatigue, and poor coping. Respiratory symptoms are also a common trigger for panic attacks in the general population. Minimal research has addressed the prevalence of panic disorder or the association of dyspnea with the risk of panic disorder in lung cancer.


OBJECTIVE
We explored the frequency of panic disorder symptoms and the association of dyspnea with the risk of panic disorder symptoms among patients with newly diagnosed non-small cell lung cancer.


METHODS
During 2006-2010, consecutive patients presenting for initial consultation at a thoracic oncology clinic completed a survey of current symptoms, including dyspnea and panic disorder symptoms. We evaluated the frequency of panic disorder symptoms. Logistic regression was used to test the association of dyspnea with the risk of panic disorder symptoms, adjusting for age, gender, disease stage, performance status, and major depression symptoms.


RESULTS
Among 624 patients (mean age=63.7; standard deviation=12.1; 52.6% female), 48.1% reported that breathing was at least somewhat difficult and 11.2% endorsed panic disorder symptoms. Dyspnea was independently associated with higher risk of panic disorder symptoms (odds ratio=2.19, 95% confidence interval=1.11-4.31, P=0.02). Younger age and major depression symptoms also were associated with higher risk (P<0.01).


CONCLUSIONS
Almost half of the patients with newly diagnosed non-small cell lung cancer reported dyspnea, and patients with dyspnea were more than twice as likely to endorse panic disorder symptoms relative to patients without dyspnea. Results highlight the need to differentiate panic disorder symptoms among patients who report dyspnea, particularly those who are younger or experiencing major depression symptoms.
Department of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA. Electronic address: jashin@mgh.harvard.edu.
Jennifer A
JA
Shin
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jesse D
JD
Kosiba
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Lara
L
Traeger
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Joseph A
JA
Greer
Department of Hematology/Oncology, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jennifer S
JS
Temel
Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
William F
WF
Pirl
D000367:Age Factors; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000453:epidemiology; D004417:Dyspnea / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000453:epidemiology*; D015995:Prevalence; D012306:Risk
Dyspnea; anxiety; lung carcinoma; panic disorder