PANIC DISORDER - ACCEPTANCE OF THE DIAGNOSTIC ENTITY AND TREATMENT MODALITIES PREFERRED BY GERMAN HEALTH-PROFESSIONALS

A survey of the pharmacological and psychological treatment of panic d isorder and agoraphobia (PDA) was conducted among 103 physicians, psyc hologists and psychotherapists. It revealed that the treatments for PD A preferred by the majority of the respondents are inconsistent with t he recommendations given in the international literature. Non-psychiat ric physicians most frequently proposed herbal preparations as a possi ble treatment (46% of non-psychiatric physicians), followed by homoeop athic formulations (32%), Tricyclic antidepressants which are recommen ded as first-line treatment in panic disorder by the literature are pr eferred by 74% of the psychiatrists, but only by 24% of the non-psychi atric physicians. Benzodiazepines ate prescribed by twice as many psyc hiatrists (45%) as non-psychiatric physicians (22%). Beta blockers and neuroleptics which are not recommended as first-Line treatment in pan ic disorder are used quite often (psychiatrists: 15%; non-psychiatric physicians: 26%). Selective serotonin reuptake inhibitors are prescrib ed by 24% of the psychiatrists, but by only 3% of the non-psychiatric physicians. Among psychological therapies, psychoanalysis was proposed as first-line treatment by 44% of all professionals applying psycholo gical therapies, while cognitive/behaviour therapy was preferred by on ly 28%, though proof of efficacy exists only for cognitive/behaviour t herapy. In general, psychologists prefer behaviourally-orientated ther apy, while physicians mostly propose psychodynamic therapy. One reason for the fact that the results of controlled studies have little influ ence an professionals treating PDA patients might be that 40% of the r espondents do not accept the new classification of the anxiety disorde rs as introduced in 1980 by the DSM-III.