Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T23:55:40.604Z Has data issue: false hasContentIssue false

Current panic symptoms among primary care physician's patients

Published online by Cambridge University Press:  11 October 2011

Maurizio Bellini*
Affiliation:
Instituto di Psichiatria “P.Ottonello”, Università di Bologna, Bologna
Elisabetta Galaverni
Affiliation:
Instituto di Psichiatria “P.Ottonello”, Università di Bologna, Bologna
*
Address for correspondence: Professor M. Bellini, Istituto di Psichiatria, Università di Bologna, Viale Pepoli 5, 40123 Bologna. Fax: +39-051-521030 E-mail: [email protected]

Abstract

Summary

Objective – On a basis of a large study on anxiety disorders and after a relevant literature review (no Italian survey being present in the last ten yrs on the specific topic), our present purpose is to estimate the one-month point-prevalence of panic symptoms in the primary care setting; to evaluate differences existing between patients with and without panic symptomatology. Methods – The sampling involves all consecutive patients visited by a primary care physician every day over four weeks during the recruitment period. Setting Primary care physician's (PCP) waiting-room, with immediate administration of inventories in the waiting room, under direct supervision of one Author (EG). Main outcome measures – Self-administered inventories as GHQ-12, STAI-Y1-Y2, Panic Attack and Anticipatory Scale. Results – Out of 409 subjects attending PCP's office during the recruitment period, 327 gave their oral consensus and 305 completed their assignments, constituting our sample. The 21.3% (65 cases) of our sample has shown panic symptoms in the last month. This subgroup with panic is significantly younger and more educated than the subgroup without panic. Moreover the female to male ratio is 2.6:1. Significant differences had been found in the health perception, which is negatively affected by the presence of panic attacks and by GHQ-12 and STAI-Y1-Y2 total scores. These scores are significantly higher than those from panicless patients. Conclusion – Our survey highlights that at least one of five patients visited by the PCP is on average suffering from panic symptoms. This might be related to the well-known physical components of panic symptomatology, but also to the increasing importance of the involved sub-threshold elements.

Declaration of Interest: no forms of support from any companies. One of the Authors (EG) had one-month fellowship at the University of Murcia relating to present research involvement.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

BIBLIOGRAFIA

Bellini, M., Bruschi, C., Isacco, S., Petio, C., Alberti, T. & Ferrari, G. (1999). Psychiatric Diagnoses Out of 24-Hour Continuous Referrals to the General Hospital Emergency Room. In Psychiatric Emergencies in a Changing World (ed. Clerq, M.De), pp.583590. Elsevier: The Netherlands.Google Scholar
Berardi, D. & Leggieri, G. (2001). Il quadro clinico. In Attidel Workshop “Psichiatria e Medicina di Base.Il Progetto della Regione EmiliaRomagna”, pp. 6782. Editrice Compositori: Bologna.Google Scholar
Berardi, D., Berti Ceroni, G., Leggieri, G., Rucci, P., Ostiin, B. & Ferrari, G. (1999). Mental, physical and functional status in primary care attenders. International Journal of Psychiatry in Medicine 29, 133148..CrossRefGoogle ScholarPubMed
Berti Ceroni, G., Berti Ceroni, F., Bivi, R., Corsino, M.A., De Marco, P., Gallo, E., Giovannini, G., Gherardi, S., Pezzoli, A., Rucci, P. & Neri, C. (1992). DSM-III mental disorders in general medical sector: a follow-up and incidence study over a two year period. Social Psychiatry and Psychiatric Epidemiology 27, 234241.CrossRefGoogle Scholar
Birchall, H., Brandon, S. & Taub, N. (2000). Panic in a general practice population: prevalence, psychiatric comorbidity and associated disability. Social Psychiatry and Psychiatric Epidemiology 35, 235241.CrossRefGoogle Scholar
Cassano, G.B. (2000). Presentazione delPedizione italiana. In Linee Guida per il Trattamento del Disturbo di Panico (ed. Cassano, G.B e Mauri, K.M.), pp.VII–VIII. Masson: Milano.Google Scholar
Cassano, G.B., Michelini, S., Shear, M.K., Coli, E., Maser, J.D. & Frank, E. (1997). The panic-agoraphobic spectrum: a descriptive approach to the assessment and treatment of subtle symptoms. American Journal of Psychiatry 154 (6), 2738.Google Scholar
Faravelli, C., Guerrini Degl'Innocenti, B. & Giardinelli, L. (1989). Epidemiology of anxiety disorder in Florence. Acta Psychiatrica Scandinavica 79, 308312.CrossRefGoogle ScholarPubMed
Frank, E., Shear, M.K., Rucci, P., Cyranowski, J.M., Endicott, J., Fagiolini, A., Grochocinski, V.J., Houck, P., Kupfer, D.J., Maser, J.D. & Cassano, G.B. (2000). Influence of panic-agoraphobic spectrum symptoms on treatment response in patients with recurrent major depression. American Journal of Psychiatry 157, 11011107.CrossRefGoogle ScholarPubMed
Gerdes, T., Yates, W.R. & Clancy, G. (1995). Increasing identification and referral of panic disorder over the past decade. Psychosomatics 36, 480486.CrossRefGoogle ScholarPubMed
Goldberg, D. & Huxley, P. (1980). Mental Illness in the Community. The Pathway to Psychiatric Care. Tavistock: London.Google Scholar
Goldberg, D.P. & Williams, P. (1988). A User's Guide to the General Health Questionnaire: GHQ. NFER-NELSON: Windsor.Google Scholar
Goodwin, R., Olfson, M., Feder, A., Fuentes, M., Pilowsky, D.J. & Weissman, M.M. (2001). Panic and suicidal ideation in primary care. Depression and Anxiety 14, 244246.CrossRefGoogle ScholarPubMed
Hazlett-Stevens, H., Craske, M.G., Roy-Byrne, P.P., Sherbourne, C.D., Stein, M.B. & Bystritsky, A. (2002). Predictors of willingness to consider medication and psychosocial treatment for panic disorder in primary care patients. General Hospital Psychiatry 24, 316321.CrossRefGoogle ScholarPubMed
Katerndahl, D.A. & Realini, J.P. (1995). Where do panic attack sufferers seek care? Journal of Family Practitioner 40, 237243.Google ScholarPubMed
Katon, W., Hollifield, M., Chapman, T., Mannuzza, S., Ballenger, J. & Fyer, A. (1995). Infrequent panic attacks: psychiatric comorbidity, personality characteristics and functional disability. Journal of Psychiatric Research 29, 121131.CrossRefGoogle ScholarPubMed
Klein, E., Linn, S., Colin, V., Lang, R., Pollack, S., Lenox, R.H. (1995). Anxiety disorders among patients in a general emergency service in Israel. Psychiatric Services 46, 488492.Google Scholar
Lecrubier, Y. & Üstiin, T.B. (1998). Panic and depression: a worldwide primary care perspective. International Clinical Psycliopliarmacology 13, Suppl. 4, S711.Google ScholarPubMed
Marino, S. & Tansella, M. (1989) I questionari come strumenti di screening nel setting della medicina di base. Quaderni Italiani di Psichiatria 8, 203215.Google Scholar
Piccinelli, M., Pini, S., Bellantuono, C., Bonizzato, P., Paltrinieri, E., Üstün, B., Sartorius, N. & Tansella, M. (1995). Lo studio internazionale multicentrico dell'Organizzazione Mondiale della Sanita sui disturbi psichici nella medicina generale: risultati relativi all'area di Verona. Epidemiologia e Psichiatria Sociale 4, 2750.CrossRefGoogle Scholar
Pini, S., Perkonnig, A., Tansella, M., Wittchen, H.-U. & Psich, D. (1999). Prevalence and 12-month outcome of threshold and subthreshold mental disorders in primary care. Journal of Affective Disorders 56, 3748.CrossRefGoogle ScholarPubMed
Rucci, P. & Maser, J.D. (2000). Instrument development in the Italy-USA Collaborative Spectrum Project. Epidemiologia e Psichiatria Sociale 9, 249256.CrossRefGoogle ScholarPubMed
Shear, M.K., Frank, E., Rucci, P., Fagiolini, D.A., Grochocinski, V.J., Houck, P., Cassano, G.B., Kupfer, D.J., Endicott, J., Maser, J.D., Mauri, M. & Banti, S. (2001). Panic-agoraphobic spectrum: reliability and validity of assessment instruments. Journal of Psychiatric Research 35, 5966.CrossRefGoogle ScholarPubMed
Shear, M.K., Cassano, G.B., Frank, E., Rucci, P., Rotondo, A. & Fagiolini, A. (2002). The panic-agoraphobic spectrum: development, description, and clinical significance. Psychiatric Clinic of North America 25 (4), 739756.CrossRefGoogle ScholarPubMed
Siracusano, A., Niolu, C. & Vella, G. (2001). La diagnosi differenziale del disturbo di panico. NóζAggiornamenti in Psichiatria 7, 4356.Google Scholar
Spielberger, C.D. (1983). Manual for the State-Trait Anxiety Inventory STAI Form Y. Consulting Psychologists Press, Palo Alto: California Trad, it.: Inventario per Vansia di “stato” e di “tratto” forma Y. Manuale. (a cura di L. Pêtrabissi e M. Santinello). Organizzazioni Speciali: Firenze, 1989.Google Scholar
Stirton, R.F. & Brandon, S. (1988). Preliminary report of a community of panic attack and panic disorder. Journal of the Royal Society of Medicine 81, 392393.CrossRefGoogle ScholarPubMed
Üstün, T.B. & Sartorius, N. (1995). Mental Illness in General Health Care. An International Study. John Wiley: Chichester.Google Scholar
Weissman, M.M., Bland, R.C., Canino, G.J., Faravelli, C., Greenwald, S., Hwu, H.G., Joyce, P.R., Karam, E.G., Lee, C.K., Lellouch, J., Lepine, J.P., Newman, S.C., Oakley-Browne, M.A., Rubio-Stipec, M., Wells, J.E., Wickramaratne, P.J., Wittchen, H.U., Yeh, E.K. (1997). The Cross-National Epidemiology of Panic Disorder. Archives of General Psychiatry 54, 305309.CrossRefGoogle ScholarPubMed
Yingling, K.W., Wulsin, L.R., Arnold, L.M. & Rouan, G.W. (1993). Estimate prevalences of panic disorder and depression among consecutive patients seen in an emergency department with acute chest pain. Journal of General Internal Medicine 8, 231235.Google Scholar