Objective: Panic disorder is a disorder characterized by recurrent unexpected panic attacks where the patient may exhibit avoidance behavior by experiencing anticipatory anxiety for further attacks. According to the DSM-IV-TR, panic disorders are divided into two types: with and without agoraphobia. Agoraphobia is an anxiety disorder in which there are repeated attacks of intense fear and anxiety, and a fear of being in places where escape might be difficult, or where help might not be available, and it results in obvious avoidance of feared places and situations. Panic attack is characterized by intense anxiety that occurs unexpectedly and spontaneously, accompanied by somatic and cognitive symptoms. A marked deterioration can be observed in patients' functions, particularly due to the anticipatory anxiety and avoidance behaviors (1,2). The cognitive rationale of panic disorder is linked to a catastrophic interpretation of bodily sensations. Negative and anxiety-related processes of thought such as heart attack, cerebral hemorrhage, and loss of control are effective in the origin of panic attacks due to a catastrophic interpretation (3). The objective of our study was to identify clinical characteristics involved in the onset and maintenance of this disorder in patients who presented to a training and research hospital.
Method: The study included 101 consecutive patients with panic disorder who presented to the clinics at the Bakirköy Hospital for Mental and Neurological Disorders, met the inclusion criteria, volunteered to participate in the study, and provided informed consent. The diagnosis was made by two psychiatrists, who were not involved in the study. The diagnosis was confirmed using the Structured Clinical Interview Form for the DSM-IV Axis I Disorders (SCID-I). The patients filled in a sociodemographic form, which examined clinical characteristics of the disease in detail, including the identifiable life events triggering the disease and the environmental conditions where the attacks developed, taking the SCID-I clinical interview guide into consideration.
Results: The mean age of participants was 36.73 ± 9.42 years (min: 19, max: 58 years). The mean age of onset was 29.94 ± 9.17 years, and the mean duration of disease was 6.73 ± 7.65 years. The sociodemographic characteristics of the participants are outlined in Table 1. Distribution of the complaints listed in accordance with the DSM-IV-TR panic disorder criteria by their incidence is provided in Table 2 (only the first 3 criteria among the DSM-IV-TR panic disorder criteria were included in the assessments). The clinical characteristics of patients specific to panic disorder are shown in Table 3.
Discussion: Understanding the clinical characteristics specific to panic disorder, which have a significant impact on the functioning of a person due to escape, avoidance, and safety seeking behaviors as a result of a catastrophic interpretation of bodily sensations, is important in conceptualization and therapeutic interventions of the disorder. In the present study, the population was not well reşected in terms of gender as participants were consecutively enrolled from the clinics of a training and research hospital. It was a single-center study, and Axis I and II comorbidities were not evaluated. We believe that further studies eliminating such limitations would be beneficial.