Panic and prolapse. Meta-analysis.

Studies concerning the association of panic disorder and mitral valve prolapse have produced mixed results. Meta-analysis was used to quantitatively review the literature and explain conflicting results. Only 19 published and two unpublished studies have documented both panic and mitral valve prolapse in addition to including a control group, and were therefore included. The strength of association between panic disorder and mitral valve prolapse was measured as the odds ratio and study variables were included in the analysis. The overall weighted relative risk was 2.3 (confidence interval, 1.6 to 3.5). Important study variables were often not addressed in the literature and stepwise multiple regression found that auscultatory criteria, control group diagnosis, and sample size predicted relative risk (F = 11.34, p < .001). p-Values differed with publication status (t = 2.32, p = .033). Although the quality of literature is uneven, there appears to be a significant association between panic disorder and mitral valve prolapse. However, the suggestion of publication bias indicates that the published literature may present a biased view.