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Am J Psychiatry 1997; 154:766-772
Copyright © 1997 by American Psychiatric Association
Panic disorder and quality of life: variables predictive of functional impairment
M Hollifield, W Katon, B Skipper, T Chapman, JC Ballenger, S Mannuzza and AJ Fyer
Department of Psychiatry and Family and Community Medicine, University of New Mexico School of Medicine, Albuquerque 87131-5326, USA.
OBJECTIVE: The authors sought to characterize the functional impairment in
patients with panic disorder, specifically the variance in impairment
explained by demographic and clinical variables. METHOD: Sixty-two patients
with panic disorder and 61 comparison subjects from three primary care
clinic sites were assessed with an adapted form of the Structured Clinical
Interview for DSM-III-R. Impairment was assessed according to three
measures from the 36-item Short-Form Health Survey (general health
perception, mental health, and physical functioning) as well as a principal
component factor of the survey. Subjects were also compared with respect to
personality variables, presence and severity of chronic medical illness,
and demographic characteristics. Stepwise multiple regressions with and
without pairwise interactions were used to construct models of disability
in the patients with panic disorder. RESULTS: The patients with panic
disorder were more impaired than comparison subjects on each measure of the
Short-Form Health Survey. The panic disorder diagnosis combined with major
depression, increasing neuroticism and age, less education, and an
interaction between panic disorder and age accounted for 48%-77% of the
variance in impairment scores. Gender and ethnicity contributed modestly to
the variance in impairment in physical functioning, whereas no contribution
was demonstrated for chronic medical illness or city of residence.
CONCLUSIONS: Factors in addition to panic phenomena contribute to the
severe impairment seen in patients with panic disorder. Further research
about factors that affect impairment may help improve clinical approaches
to this illness.
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