Comorbidities, medical service use predict panic disorder

  • J Psychosom Res.
  • 20 Aug 2019

  • International Clinical Digest
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Takeaway

  • Panic disorder is more common among patients with certain comorbidities and patterns of using medical services.

Why this matters

  • Primary care physicians should review psychiatric comorbidities to evaluate risk for panic disorder, especially in patients with greater use of outpatient services.

Study design

  • 9759 patients with panic disorder and 39,036 matched control individuals were identified from the Taiwan National Health Insurance Research Database (2000-2013).
  • Funding: Taiwan Ministry of Science and Technology; others.

Key results

  • In the year preceding diagnosis, patients with panic disorder were more likely to have (all P<.001 style="list-style-type:circle;">
  • Physical comorbidities:
    • Cardiovascular disease (adjusted risk ratio [aRR], 3.44).
    • Asthma (aRR, 1.76).
    • COPD (aRR, 1.40).
    • Upper respiratory tract infection (aRR, 1.22).
  • Psychiatric comorbidities:
    • Drug-induced mental disorders (aRR, 2.19).
    • Schizophrenia (aRR, 1.81).
    • Bipolar disorder (aRR, 2.68).
    • Depressive disorder (aRR, 5.91).
    • Other anxiety disorders (aRR, 7.08).
    • Adjustment disorder (aRR, 4.82).
    • Sleep disorder (aRR, 2.48).
  • Most cases of panic disorder were diagnosed in the Department of Psychiatry (58.5%), followed by Internal Medicine (15.4%), Family Practice (8.9%), Neurology (7.4%), and Emergency Medicine (3.7%).
  • Emergency department visits were more common with panic disorder than the general population (RR, 2.12; P<.0001>

    Limitations

    •  Data on potential factors influencing panic disorder not captured.

    Co-authored with Chitra Ravi, MPharm