Ts. Zaubler et W. Katon, PANIC DISORDER AND MEDICAL COMORBIDITY - A REVIEW OF THE MEDICAL AND PSYCHIATRIC LITERATURE, Bulletin of the Menninger Clinic, 60(2), 1996, pp. 12-38
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.