CHARACTERISTIC CLINICAL-FEATURES AND CLINICAL COURSE IN 270 JAPANESE OUTPATIENTS WITH PANIC DISORDER

We investigated the clinical characteristics of panic disorder (PD) in a Japanese outpatient population comprising 270 patients diagnosed as having PD (among a total of 9219 new outpatients treated at our psych iatric clinic) during a 13-year study period from 1981 to 1994, accord ing to either DSM-III (1981-1987) or DSM-III-R (1988-1994) criteria Th e sex ratio was 1:1.14 (males, 126; females, 144). There was no differ ence between male and female patients in the prevalence of agoraphobia (males, 51; females, 59). Frequencies of the following symptoms durin g panic episodes in our Japanese patients were significantly lower tha n those reported in other studies: trembling or shaking, sweating, cho king, nausea, sense of depersonalization, numbness or tingling sensati ons, flushes or chills, and fear of going crazy. Frequency of other sy mptoms during episodes, such as dyspnea, dizziness, palpitation, and f ear of dying, was similar to that reported in the literature. Incidenc e of comorbidity with major depressive disorder, suicide attempt, or s uicidal ideation was very low; none of the patients had been diagnosed with major depression at the first interview, 4.4% had had suicidal i deas, and 0.4% had attempted suicide during the clinical course. These findings suggest that PD in Japanese patients may be characterized by relatively mild panic symptoms and may not feature a depressive compo nent. In 62.2% of all medicated patients, panic attacks disappeared, a nd duration until disappearance was less than 1 month in most patients . Only 13.3% (27/203) of the patients showed complete remission at the follow-up assessment. The chronicity of PD described in the literatur e was found in this Japanese outpatient population as well.