M. Hollifield et al., PANIC DISORDER AND QUALITY-OF-LIFE - VARIABLES PREDICTIVE OF FUNCTIONAL IMPAIRMENT, The American journal of psychiatry, 154(6), 1997, pp. 766-772
Objective: The authors sought to characterize the functional impairmen
t in patients with panic disorder, specifically the variance in impair
ment explained by demographic and clinical variables. Methods: Sixty-t
wo patients with panic disorder and 61 comparison subjects from three
primary care clinic sites were assessed with an adapted form of the St
ructured Clinical Interview for DSM-III-R. Impairment was assessed acc
ording to three measures from the 36-item. Short-Form Health Survey (g
eneral health perception, mental health, and physical functioning) as
well as a principal component factor of the survey. Subjects were also
compared with respect to personality variables, presence and severity
of chronic medical illness, and demographic characteristics. Stepwise
multiple regressions with and without pairwise interactions were used
to construct models of disability in the patients with panic disorder
. Results: The patients with panic disorder were more impaired than co
mparison subjects on each measure of the Short-Form Health Survey. The
panic disorder diagnosis combined with major depression, increasing n
euroticism and age, less education, and an interaction between panic d
isorder and age accounted for 48%-77% of the variance in impairment sc
ores. Gender and ethnicity contributed modestly to the variance in imp
airment in physical functioning, whereas no contribution was demonstra
ted for chronic medical illness or city of residence. Conclusions: Fac
tors in addition to panic phenomena contribute to the severe impairmen
t seen in patients with panic disorder. Further research about factors
that affect impairment may help improve clinical approaches to this i
llness.