PRIMARY-CARE PHYSICIAN RESPONSES TO A PANIC DISORDER VIGNETTE - DIAGNOSTIC SUSPICION AND CLINICAL MANAGEMENT

Objective: To study current patterns of panic disorder (PD) recognitio n acid management by primary care physicians (PCPs). Method: We admini stered a vignette describing a female PD patient to 189 PCPs. Results: Three-quarters of respondents believed that PD was at least 50 percen t probable, and the mean PD likelihood rating was 63 percent. Diagnost ic suspicion was significantly higher for PD than for other anxiety di sorders, major depressive disorder, and cardiac disorders. Medication was rated as significantly more necessary than medical testing and men tal health referral. A benzodiazepine was suggested by 78 percent of r espondents, while 35 percent suggested a serotonin reuptake inhibitor (SRI). Under half rated the patient as requiring medical testing, most ly for hyperthyroidism (70%) and/or cardiovascular disorder (62%), and half felt that the patient required mental health referral. Conclusio ns: The data suggest that most PCPs are able to recognize PD. However, they may be excessively inclined to prescribe benzodiazepines rather than more appropriate medications.