[Possible subtypes of panic disorder].

OBJECTIVE

The present study, is aimed to investigate the distributiondispersion of panic attack symptoms, the possible subtypes of panic disorder, and the clinical features related to these subtypes in patients with panic disorder.

MATERIAL AND METHODS

The study included 105 patients that presented to the Ondokuz Mayıs University Faculty of Medicine Psychiatric Outpatient Clinic and met the DSM-IV-TR diagnostic criteria for panic disorder. The Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I), Panic Attack Symptom Checklist (PASC), Structured Clinical Interview for DSM-III-R (SCID-II), Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), Panic Disorder Severity Scale (PDSS), and Panic and Agoraphobia Scale (PAS) were administered to all the patients. This study examined the correlation between clinical scales and the factors based on factor analysis using PASC.

RESULTS

The 3 most frequently observed symptoms during panic attacks were palpitation, sensations of shortness of breath, and sensation of choking, and the 3 most severe were palpitation, chest pain, and sensation of shortness of breath. The 3 most frequently observed non-DSM-IV-TR symptoms were feeling of discomfort, dry mouth, and blurred vision. As a result of our analysis, 3 factors were defined: respiratory-circulatory, cognitive, and autonomic. Panic attack severity, panic attack frequency, and grade of agoraphobia were strong predictors of the respiratory-circulatory subtype; anticipatory anxiety was a strong predictor of the cognitive subtype. Grade of being anxious for health was stronger predictor for respiratory-circulatory subtype, predictor for the "autonomic" subtype, and a reverse predictor for the cognitive subtype.

CONCLUSION

It should be considered that the panic attack symptoms in DSM-IV-TR are insufficient to determine the panic disorder subtypes that are based on symptom profiles. The determination of subtypes could contribute in prognosis of disorder and studies about treatment methods.