CLINICAL CHARACTERISTICS OF PATIENTS WITH CONCURRENT MAJOR DEPRESSIVEDISORDER AND PANIC DISORDER

Objective: This study was designed to test the hypothesis that patient s with both major depressive disorder and panic disorder exhibit more clinical symptoms and have a more protracted course of illness than pa tients with major depressive disorder only. Method: The authors compar ed standardized clinical evaluations (from Schedule for Affective Diso rders and Schizophrenia interviews) of 119 patients with major depress ive disorder only and 57 patients with major depressive disorder and c oncurrent panic disorder. Clinical and demographic variables were incl uded. Results: The patients with both disorders reported symptoms of m ajor depressive disorder earlier in life and also required treatment a nd hospital admission earlier in life. Many clinical features during t he index episode were significantly more severe in the patients with b oth disorders. A logistic regression identified a ''panic index'' cons isting of the symptoms of somatic anxiety, phobia, indecisiveness, and feelings of inadequacy. Scores on this index allowed proper classific ation of patients to either of the two diagnostic groups with high rel iability. Conclusions: In major depressive disorder, the presence of p anic disorder is suggestive of a more severe and precocious form of il lness.