PANIC DISORDER AND MEDICAL COMORBIDITY - A REVIEW OF THE MEDICAL AND PSYCHIATRIC LITERATURE

Epidemiological studies have found significant comorbidity between pan ic disorder and many medical illnesses. The authors discuss the accumu lating psychiatric and medical literature addressing comorbidity betwe en panic disorder and cardiac, respiratory, gastrointestinal, and neur ological illnesses. Cardiac symptoms such as chest pain and palpitatio ns, as well as certain disorders such as mitral valve prolapse, hypert ension, and cardiomyopathy, share significant comorbidity with panic d isorder. Researchers have also shown significant comorbidity between p anic disorder and chronic obstructive pulmonary disease, irritable bow el syndrome, and migraine headache. Pathophysiological mechanisms that may explain the association between panic disorder and comorbid medic al illnesses, such as autonomic dysregulation of cardiac activity and smooth muscle tone and dynamic abnormalities of the coronary microvasc ulature, are discussed as well.