Panic disorder subtypes: further clinical differences

Depress Anxiety. 2007;24(7):479-86. doi: 10.1002/da.20253.

Abstract

Panic disorder (PD) is a heterogeneous phenomenon with respect to symptom profile. Most studies agree that a group of patients with prominent respiratory symptoms emerged as a distinct PD subtype. In this study we compared a range of clinical features associated with PD and agoraphobia in patients with respiratory (RS) and nonrespiratory (NRS) subtypes of PD. The participants were 124 patients with PD (79 women and 45 men), with or without agoraphobia, diagnosed by DSM-IV criteria. Following the observer-rated Panic Disorder Severity Scale assessment, subjects completed self-report measures, including the Anxiety Sensitivity Index (ASI), Panic-Agoraphobia Scale; the Beck Anxiety Inventory; and the Panic-Agoraphobic Spectrum Scale (PAS-SR). Multivariate analysis of variance (MANOVA) showed significant group differences [Pillai's trace = 0.95, F (5, 118)(=)2.48, P = .036]. Patients in RS group had higher mean total scores on the ASI (F = 5.00, df = 1, P = .027) and PAS-SR (F = 11.23, df = 1, P = .001) than patients in NRS group. Also, patients with RS attained higher scores than patients with NRS on four domains of PAS-SR (panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking). A descriptive discriminant analysis of the data correctly identified 69.4% of the patient group in general and 86.1% of RS group (Wilks's lambda = 0.87, df = 8, P = .048). The significant discriminating factors of the RS and NRS groups were domains of panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking. Our findings suggest that anxiety sensitivity and panic-agoraphobic spectrum symptoms might be particularly relevant to understanding subtypes of PD.

MeSH terms

  • Adult
  • Agoraphobia / classification
  • Agoraphobia / diagnosis*
  • Agoraphobia / psychology
  • Anxiety Disorders / classification
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Cross-Cultural Comparison
  • Female
  • Humans
  • Hyperventilation / psychology*
  • Language
  • Male
  • Middle Aged
  • Panic Disorder / classification
  • Panic Disorder / diagnosis*
  • Panic Disorder / psychology
  • Personality Assessment / statistics & numerical data
  • Personality Inventory / statistics & numerical data
  • Psychometrics / statistics & numerical data
  • Reproducibility of Results
  • Turkey