Article Figures & Data
Tables
Setting Prevalence of Panic Disorder Family practice7 25% Emergency department17,18 18%–26% Atypical chest pain19,20 16%–47% Referral population GI Lab (no CAD)21 34% Cardiology22 38% Negative work-up9,23 27%–37% For cardiac testing24 47% For angiography25 10% Cardiology26–28 9%–57% Sent for ECG22,29 62% No CAD30 34%–41% With atypical chest pain31,32 41%–59% Clinic with nonischemic pain33 22% Coronary care unit34 31% Other Minimal/no CAD35,36 30%–43% Noncardiac chest pain37 53% Cardiac neurosis38 17% A. Both (1) and (2): (1) Recurrent unexpected panic attacks Discrete episode of intense fear starting abruptly and peaking within 10 minutes, including at least four of the following symptoms: palpitations, sweating, trembling, dyspnea, choking, chest pain, nausea, dizziness, depersonalization, chills/hot flashes, paresthesias, fear of dying, fear of losing control. (2) At least one of the following: persistent concern about future attacks, worry about consequences of attacks, change in behavior due to attacks B. Presence or absence of agoraphobia C. Attacks are not due to substances or general medical condition D. Attacks are not better accounted for by another mental disorder - Table 3.
Included Studies Assessing the Relationship between Nonanginal Pain and Panic Disorder in Patients Presenting to Emergency Departments for Chest Pain
Sample Size Results Criteria for ′Angina′ Criteria for ′Panic Disorder′ 12917 
Substernal + Exertional + Relief with NTG/Rest SCID† 18018 Substernal + Exertional + Relief with NTG/Rest ADIS 44142 Substernal + Exertional + Relief with NTG/Rest ADIS * 2 × 2 table in which the presence or absence of panic disorder is indicated in the left and right columns, respectively, and the presence or absence of angina is indicated in the top and bottom rows, respectively.
† SCID, structured clinical interview of the DSM; ADIS, anxiety disorders interview schedule.
- Table 4.
Included Studies Assessing the Association between Panic Disorder and Coronary Artery Disease in Patients with Chest Pain
Setting Sample Size Results Criteria for ′CAD′ Criteria For ′Panic Disorder′ Emergency department 22917 Abnormal angiogram or ETT†/acute MI by EKG or enzyme criteria/history of MI or abnormal cardiac evaluation SCID 18018 Previous MI, PTCA, or CABG/angiogram with >50% stenosis/abnormal thallium ETT ADIS 44152 Previous MI, PTCA, or CABG/angiogram with >50% stenosis/abnormal thallium ETT ADIS Cardiology 11333 Abnormal ETT DIS 9824 No previous CAD/angiogram with >50% Stenosis/abnormal ETT DIS 7435 No previous CAD/abnormal angiogram 3053 Abnormal thallium ETT ADIS 19922 No previous CAD/abnormal ETT SCID * 2 × 2 table in which the presence or absence of panic disorder is indicated in the left and right columns, respectively, and the presence or absence of CAD is indicated in the bottom and top rows, respectively.
† ADIS, anxiety disorders interview schedule; SCID, structured clinical interview of the DSM; DIS, diagnostic interview schedule; DSM, Diagnostic and Statistical Manual of Mental Disorders; MI, myocardial infarction; ETT, exercise treadmill test; PTCA, percutaneous transluminal coronary angioplasty; CABG, coronary artery bypass graph.
Setting Prevalence of Panic Disorder [% (95% CI)] Emergency department17 6 (3–9) No cardiac cause52 34 (23–45) Referral populations GI laboratory21 49 (37–61) For cardiac testing24 6 (0–13) For angiography25 0 (not calculable) Cardiology27,70 22 (7–37), 27 (14–40) Atypical chest pain32 52 (34–70) Clinic33 10 (0–23) Other General35 7 (0–14) Post-myocardial infarction78 6 (1–11) Microvascular angina79 40 (15–65) Setting Prevalence of CAD [% (95% CI)] Primary Care55 4 (0–8) Emergency department18 55 (40–70) Cardiology28 44 (30–58) Atypical chest pain32 27 (15–39) Other General35 20 (0–41) Any cardiovascular disease34,60 8 (1–15), 21 (2–40) Population Correlates Emergency department Younger age17,18,42 Atypical chest pain18 Elevated levels Depression42 Anxiety42 Phobia42 Cardiology Demographics Younger age27 Female27 Unemployed27 Less education27 Lower income27 Elevated levels Pain22,27 Hypochondriasis22 Somatosensory amplification27 Presence of Agoraphobia22 GAD22 Major depression22 Somatoform disorder22 Personality disorder (bipolar disorder, avoidant)109
