Am J Psychiatry 1994; 151:541-546
Copyright © 1994 by American Psychiatric Association
Clinical characteristics of patients with concurrent major depressive disorder and panic disorder
L Grunhaus, AC Pande, MB Brown and JF Greden
Department of Psychiatry, University of Michigan.
OBJECTIVE: This study was designed to test the hypothesis that patients
with both major depressive disorder and panic disorder exhibit more
clinical symptoms and have a more protracted course of illness than
patients with major depressive disorder only. METHOD: The authors compared
standardized clinical evaluations (from Schedule for Affective Disorders
and Schizophrenia interviews) of 119 patients with major depressive
disorder only and 57 patients with major depressive disorder and concurrent
panic disorder. Clinical and demographic variables were included. RESULTS:
The patients with both disorders reported symptoms of major depressive
disorder earlier in life and also required treatment and hospital admission
earlier in life. Many clinical features during the index episode were
significantly more severe in the patients with both disorders. A logistic
regression identified a "panic index" consisting of the symptoms of somatic
anxiety, phobia, indecisiveness, and feelings of inadequacy. Scores on this
index allowed proper classification of patients to either of the two
diagnostic groups with high reliability. CONCLUSIONS: In major depressive
disorder, the presence of panic disorder is suggestive of a more severe and
precocious form of illness.
