Am J Psychiatry 1994; 151:871-875
Copyright © 1994 by American Psychiatric Association
Ataque de nervios and panic disorder
MR Liebowitz, E Salman, CM Jusino, R Garfinkel, L Street, DL Cardenas, J Silvestre, AJ Fyer, JL Carrasco and S Davies
Hispanic Anxiety Disorders Clinic, New York State Psychiatric Institute, NY 10032.
OBJECTIVE: Ataque de nervios ("attack of nerves") is an illness category
used frequently by Hispanic individuals to describe one or more particular
symptom complexes. A review of the literature on ataque suggested some
overlap with panic disorder. This study investigated the overlap with panic
disorder as well as other DSM-III-R axis I disorders. METHOD: Hispanic
subjects seeking treatment at an anxiety disorders clinic (N = 156) were
assessed with a specially designed questionnaire for self-report of ataque
de nervios and panic symptoms and with structured or semistructured
psychiatric interviews for axis I disorders. RESULTS: Seventy percent of
the subjects reported at least one ataque de nervios; 80% of these were
female, whereas 57% of the group without these attacks were female. There
were no differences in DSM-III-R diagnoses between the groups with and
without ataque de nervios. Ataque was frequently associated with one or
more anxiety and affective disorders, including panic disorder, generalized
anxiety disorder, recurrent major depression, and anxiety not otherwise
specified. Of the 45 subjects with both ataque de nervios and primary panic
disorder, 80% appeared to have labeled panic disorder as ataque. Ataque de
nervios was associated with panic symptoms even in subjects without panic
disorder, but the self-reporting of ataque conveyed additional clinical
information about the subjects with panic disorder. Ataque de nervios was
similar in frequency and symptoms among subjects of Dominican and Puerto
Rican origin. CONCLUSIONS: Ataque de nervios overlaps with panic disorder
but is a more inclusive construct. Further study of its interrelation with
axis I disorders is needed.
